延边地区尿路感染常见病原菌及耐药性分析

Distribution and Resistance of Pathogenic Bacteria in Urinary Tract Infections in Yanbian Region

目的了解延边地区成人尿路感染病原菌流行分布特点及耐药现状,正确制定治疗指南,恰当评定措施有效性。方法选择2006年11月-2007年8月,441例尿路感染患者的中段尿进行细菌培养,分离鉴定病原菌,并进行药敏试验。结果共分离出病原菌100株,革兰阴性菌65株,占65.0%,革兰阳性菌22株,占22.0%,真菌13株,占13.0%;革兰阴性菌前3位分别是大肠埃希菌(ECO)41株(41.0%)、阴沟肠杆菌(ECL)12株(12.0%)、肺炎克雷伯菌(KPN)5株(5.0%);革兰阳性菌以肠球菌属为主18株(18%);ESBLs确证试验结果ECO、KPN产酶率分别为58.5%、60.0%;药敏试验结果(除真菌外)大多数病原菌呈现出高度多药耐药现象,但革兰阴性菌对亚胺培南的耐药率为0,而革兰阳性菌对万古霉素的耐药率为4.5%。结论病原菌的耐药性严重,应密切监测和控制,合理使用抗菌药物。

ORJECTIVE To master the distribution and resistance of the isolates from adult urinary tract, in order to make correct treatment plan, and elvaluate the effect of treatment measures. METHODS The bacteria were isolated from meidstream urine of 441 urinary tract infection patients from Nov 11, 2006 to Aug 8, 2007, and the resistance of bacteria was detected. RESULTS The total number of isolated pathogenic bacteria was 100. Among them, the Gram-negative bacteria, Gram-positive bacteria and fungi were 65 （65%）, 22（22%） and 13 （13%）, respectively. The top three of Gram-negative bacteria were Escherichia coli （41 %） , Enterobacter cloacae （12 %） , and Klebsiella pneumoniae （5 %）. 58.5 % E. cloacae and 60 % K. pneumoniae could produce extended spectrum β-lactamases （ESBLs）. The most of bacteria were multi-resistant to antibiotics, but all of isolated Gram-negative bacteria were sensitive to imipenem and 4. 5% strains of Gram-positive bacteria were resistant to vancomycin. CONCLUSIONS The resistance of pathogenic bacteria is serious, so their resistance and administration of antibiotics must be monitored and controlled.