病原菌在泌尿系感染中的分布及耐药性分析

The distribution and drug resistance of pathogenic bacteria in urinary system infection

目的探讨泌尿系感染病原菌的分布及耐药状况,为临床诊断和治疗泌尿系感染疾病提供可靠的依据,指导临床合理用药。方法回顾性分析近2年来本院住院及门诊泌尿系感染患者尿培养结果,分离出382株病原菌进行鉴定和耐药性分析。结果病原菌以革兰阴性杆菌为主,占70.0%以上。革兰阴性杆菌中大肠埃希菌检出率最高,占50.3%;其次为肠球菌属,占13.7%,且比例有逐渐升高趋势。大肠埃希菌对亚胺培南耐药率最低,为2.6%,而对大部分β-内酰胺类药物的耐药率大于35.0%;肠球菌属耐药率为38.0%～90.0%,对万古耐药率为3.8%。结论泌尿系感染主要病原菌为肠杆菌科细菌,对头孢菌素和喹诺酮类药物耐药率明显升高,临床应依据药敏试验结果合理选用抗菌药物,减少耐药性播散。

Objective To investigate the distribution and drug resistance of pathogenic bacteria in urinary system infection, and to provide reliable evidence for diagnosis and treatment of urinary system infectious disease and guide the rational administration of antibiotics. Methods The clinical data of urine culture samples from the inpatients and outpatients during the last two years was retrospectively analyzed, including bacterial identification and drug resistance of 382 clinical isolates. Results The gram negative bacilli were predominant bacteria, and their detection rate exceeded 70.0%, in which Escherichia coli accounted for 50.3%, followed by Enterococci （13.7%）. Moreover, the detection of Enterococci displayed a elevating trend. The drug resistance rate of E. coli to imipenem was the lowest （2.6 %）. but higher to most beta-lactam antibiotics （〉 35.0% ）. The Enterococci were resistant to common antibiotics （drug resistance rate： 38. 0%-90%）,but sensitive to vancomycin with a low resistance rate （3.8%）. Conclusion The main pathogens are Enterobacteriaceae in urinary system infection. The pathogenic bacteria were highly resistant to cephalosporins and quinolones. Antibiotics should be used rationally according to drug susceptibility test results so as to diminish the spread of drug resistance.