498株泌尿系感染病原菌的分布及耐药性调查

INVESTIGATION OF DISTRIBUTION AND DRUG RESISTANCE STATUS OF 498 STRAINS IN URINARY SYSTEM INFECTIONS

[目的]了解泌尿系感染病原菌的分布及耐药性,为临床提供可靠的诊断和治疗依据。[方法]回顾性地分析某院2006年1～12月间,门诊及住院患者尿培养分离出的病原菌进行常规鉴定,药敏试验采用K-B法测定。[结果]分离的498株病原菌中67.02%(334株)为革兰阴性杆菌,其中大肠埃希菌221株,占分离菌株的44.37%(221/498),占革兰阴性杆菌的66.16%(221/334);革兰阳性球菌164株,占32.91%,其中,肠球菌属81株,占16.26%,葡萄球菌属55株,占11.03%;非发酵菌20株,占6.00%;真菌10株,占2.00%。大肠埃希菌和肺炎克雷伯菌均有产ESBLs菌株,其ESBLs检出率分别为25.33%和41.66%,革兰阴性杆菌对亚胺培南耐药率最低,对三代头孢菌素及喹诺酮类的耐药性较高。革兰阳性球菌未见对万古霉素、替考拉宁耐药。MRSA和MRCNS及耐高浓度庆大霉素肠球菌对多种抗菌药物表现为高度的耐药性。[结论]肠杆科细菌、肠球菌属和葡萄球菌属是我院泌尿系感染的主要病原菌;应加强泌尿系感染中致病菌及其对抗菌药物的耐药性监测。

[ Objective] To determine the bacterial distribution and drug resistance status in urinary system infections. [Methods] A total of 498 strains collected from inpatients＇ and outpatients＇ urine specimens during Jan.2006 to Dec.2006 were identified, Kirby- Bauer test was used for drug sensitivity test. [ Results] 334 strains gram-negative bacillus were detected, the detection rate was 67.02%. 221 strains Escheriehia eoli were detected, the detection rate was 44.37%, while in gram-negative bacillus, it was 66.16%. 164 strains of gram-positive coccus were detected, the detection rate was 32.91%, among which enterococeus and staphylococcus was 16.26% and 11.03% respectively. The detection rate of non-zymogenic bacteria and tungi was 6.00% and 2.00% respectively. ESBLs-produeing test was performed by standard diffusion test in Escherichia eoli and Klebsiella pneumoniae, the detection rate was 25.33% and 41.66% respectively. In gram-negative bacillus, the drug resistance to imipenem was the lowest, third generation cephalosporin and quinolones were higher. Gram-positive coccus was all sensitive to vancomycin and Teicoplanin. MRSA, MRCNS and resistant to high concentration gentamicin Enteroeoceus displayed higher drug resistant to most antibacterials. [ Conclusion] Enterubacteriaeeae, Enteroeoccus and Staphylococcus are the main infectious bacteria in urinary infection. Rational use of antibacterials should be carried out according to urine culture result.