452例清洁中段尿细菌培养和药敏结果分析

An Analysis of the Distribution and Antibiotic Resistance of Pathogens Isolated from Clean Catch Midstream Urine of 452 Patients

目的探讨尿路感染致病菌的分布及其对抗生素的耐药情况，指导临床合理选择抗生素。方法对2004年1月-2005年12月期间临床疑诊尿路感染患者的清洁中段尿细菌培养和药敏结果进行回顾性研究。结果452例患者中190例（42％）清洁中段尿培养达到尿路感染诊断标准，致病菌193株，3例为复合菌感染，其中革兰阴性杆菌占72．0％，以大肠埃希菌（46．6％）最常见；革兰阳性球菌占21．3％，以凝固酶阴性葡萄球菌（14．5％）最常见；真菌占6．7％。大肠埃希菌对呋喃妥因、第4代头孢菌素头孢吡肟耐药性较低，耐药率分别为7．1％，6．8％．结论大肠埃希菌仍然是尿路感染的主要致病菌。致病菌的耐药性普遍增高，故尿路感染治疗前应首先进行清洁中段尿培养和药敏试验，然后根据药敏试验结果合理调整抗生素。

Objective To investigate the distribution and antibiotic resistance of pathogens causing urinary tract infection, in order to improve antimierobial therapy. Methods Distribution and antibiotic resistance of pathogens in 190 culture-positive urinary tract infection patients from 2004 to 2005 were analyzed. Results Gram-negative bacilli accounted for 72.0% ,with 46.6% of E. Coll. Gram-positive cocci accounted for 21.3%, with 14.5% of clotting enzyme-negative staphylococci ;and fungi accounted for 6.7%. The resistance rate of E. Coil to nitrofurantoin and cefepime were low（ 7.1% ,6.8% respectively ）. Conclusion E. Coil is still the major pathogen of urinary tract infection. A substantial proportion of pathogens are resistant to antibiotics,so mid-stream urine euhure and susceptibility test should be taken before treatment,and antimicrobial therapy shouht be adjusted reasonably according to the results of susceptibility test.