成人社区获得性尿路感染细菌病原学研究

BACTERIAL ETIOLOGY RESEARCH OF ADULTS COMMUNITY-ACQUIRED URINARY TRACT INFECTION

[目的]探讨近年成人社区获得性尿路感染(CA-UTI)细菌病原学特点。[方法]采用法国Bio Merieux VITEK2型全自动微生物仪对CA-UTI患者432株细菌进行菌种鉴定(ID卡)及药物敏感试验(AST卡),用WHONET5软件统计出细菌构成比与耐药率。[结果]检测标本的细菌分离率为39.1%(402/1027),检出细菌中革兰阴性菌占77.8%(336/432),其中大肠埃希菌占51.4%(222/432)。革兰阴性菌对新型β-内酰胺类最敏感,其次为阿米卡星及第三代头孢菌素,对氨苄西林、头孢唑啉、磺胺等高度抗药。革兰阳性菌对左氧氟沙星、氨苄西林/舒巴坦及利福平等较敏感。[结论]成人CA-UTI病原菌构成在发生变迁,细菌的耐药性也在发生改变,做好各地各时期感染性疾病病原检测及耐药性监测,可提高病原学诊断水平和用药选择水平,提高医疗质量。

[ Objective ] To explore the bacterial etiology feature of community-acquired urinary tract infection （CA-UTI） in recent years. [ Methods] French Bio merieux VITEK 2-automatic microbial instrument was used to identify the category （ID card） and test the drug susceptibility （AST card） of 432 strains of bacteria. The bacteria composing ratio and drug resistance rate were also deternfined.[Results] The bacteria isolated rate was 39.1% （402/1027） . Gram-negative bacilli bacteria accounted for 77.8% （336/432） and escherichia coli accounted for 51.4% （222/432） . Gram-negative bacteria was most sensitive to new beta-lactam, amikaein and third-generation cephalosporins was the second. It had high resistance to ampieillin, cefazoin and sulphanilamide. Gram-positive bacteria was most sensitive to levofloxacin, ampicillin/sulbactam and rifampin. [ Conclusion] The composition of adult CA-UTI pathogens is changing and the resistance of bacteria is also changing. The pathogenic detection of infectious diseases and monitoring of resistance can improve the diagnosis of etiology, treatment options and medical quality.