妇科患者生殖道感染病原菌的分布及耐药性分析

Research on the Distribution and Antibiotic Resistance of Bacteria in genital Tract of Gynecology

目的:了解妇科患者生殖道感染病原菌分布及耐药性情况。方法:标本分离培养后,予以鉴定到种并进行相应的药敏试验。结果:5259份生殖道标本分离出3083份阳性标本,培养阳性率为58.6%。这3083株病原菌中,革兰氏阳性菌占检出菌的74.5%,以葡萄球菌和白色念珠菌占多数。革兰氏阴性菌占检出菌的25.5%,以大肠埃希氏菌为主。生殖道感染最常见的病原菌依次为大肠埃希氏菌(占21.7%),表皮葡萄球菌(占18.4%),真菌(占18.0%,以白色念珠菌为主,占检出真菌的72.9%)腐生葡萄球菌(占11.5%),肠球菌(占10.3%),金黄色葡萄球菌(占9.5%)。大肠埃希氏菌对丁胺卡那,三四代头孢类抗菌素耐药率在15%以下,对氨曲南耐药率在25%以下,而对阿莫西林耐药率在80%以上,对庆大,环丙沙星,复方新诺明,一二代头孢类抗菌素耐药率均在30%以上;葡萄球菌对万古霉素耐药率在2%以下,对三四代头孢类抗菌素耐药率在10%以下,对一二代头孢类抗菌素耐药率在20%左右,对青霉素类,红霉素,环丙沙星,复方新诺明耐药率均在50%以上,对庆大耐药率在80%左右。肠球菌除对万古霉素耐药率在5%以下外,对其余各种抗菌素均有不同程度较高的耐药率。真菌感染率明显上升。结论:临床医生要根据生殖道标本培养结果,合理使用抗菌素,以减少细菌耐药性的产生。

Objective： To study the distribution and antibiotic resistance of pathogenic bacteria. Meth- od： The antibiotic susceptibility test were detected after cuhring the samples. Result： 3083 of 5259 samples in genital tract were positive specimens（ 58.6% ）. Most of the bacteria is staphylococus and candida albicans in the detected gram - positive bacteria（74.5% ）. while, Colon bacillus is the main gram - negative one （25.5% ）. And most of the pathogenic bacteria in genital tract is colon bacillus（21.7% ） staphylococus epi- dermidis（ 18.4% ）, eumycetes（ 18.0% ）, candida is the main bacteria in eumycetes（72.9% ）. Staphyloco- cus saprophyticus （ 11.5% ）, entercocolli （10.3%） and staphylococcus aureus （9.5%）. The resistance rate of colon bacillus to amikacin, the third and forth generation cephalosporin, aztreonam, ainoxicillin is 〈 15%. 〈25% and 80%, respectively. However which is over 30% to gentamicin, ciprofoxacin and SMZ- TMP. While the resistance rate of staphylococcus to vancomycin , the third and forth generation cephalospo- rin, peniciuin, etc, gentamicin is 〈2%, 〈 10%, 20% or so, 〉50%, 〉80% respectively. Eumycetes infection is increased. Conclusion： It′s suggest that the doctor should use the antibiotic according to the cul- rived result of genital tract to decrease the drug resistance.