泌尿系感染的病原菌分布及耐药性分析

Pathogenic bacteria disrtibution and drug resistance of urinary system infection

目的了解泌尿系感染的菌群分布及耐药性状况,为临床合理使用抗菌药物提供依据。方法按照《全国临床检验操作规程》要求操作,采用法国生物梅里埃公司API系统进行细菌鉴定,药敏试验采用K-B法,对临床分离的389株病原菌进行细菌鉴定和药物敏感试验。结果在分离出的389株病原菌中,革兰阴性菌占68.9%、革兰阳性菌占25.2%;分离数在前五位的病原菌依次为大肠埃希菌(51.4%)、凝固酶阴性葡萄球菌(10.8%)、肠球菌属(9.5%)、肺炎克雷伯菌(4.9%)、铜绿假单胞菌(3.6%);检出产超广谱β-内酰胺酶(ESBLs)菌68株,其中大肠埃希菌产ESBLs63株,占31.5%;肺炎克雷伯菌产ESBLs5株,占26.3%。结论革兰阴性杆菌为尿路感染的主要病原菌,对常用抗菌药物耐药率呈上升趋势,临床应根据药敏试验结果合理使用抗菌药物。

Objective To understand patpogen distribution and drug resistance of urinary system infection, and to provide the information for choosing suitable antibiotic.Methods Totally 389 strains of pathogenic becteria derived from the chnical urinary system infection were analyzed according to the requirements described in the National Regulations on Clinicail Laboratory Operations. The bacteria were identified by the automated analyzer API made by Bio-Merieux Company in France and the drug resistance was analyzed with the K-B test. Results In the 389 strains of bacteria, 68.9% were Gram-negative and 25.2 % were Gram-positive. The first 5 were Escherichia coli （51.4%）, cogulasenegative Staphylococcus （CNS, 10.8% ）, Enterococcus （9.5%）, Klebsillla pneumoniae （4.9%）, Pseudomonas aeruginosa（3.6% ）. 68S trains produced extended-spectrum beta-lactamases（ ESBLs）. 31.5 % （63stains） of them were Escherichia and 26.3 % percent （5Strains） were Klebsiella pneumoniae. Conclusion G bacilli are the main infections pathogens inurinary tract infection and antibiotic resistance rates continue to evolve, the clinic should reasonabiy choose the antibiotics according to the test results of the pathogens sensitivity to drugs.