1513例尿路感染患者病原菌分布及药敏结果分析

Distribution and Drug Sensitivity of Pathogenic Bacteria among 1513 Cases with Urinary Tract Infection

目的了解尿路感染病原菌的分布及耐药现状,为临床合理使用抗菌药物提供依据。方法对1513例尿路感染患者进行尿标本细菌培养及药敏试验。结果尿路感染以革兰阴性杆菌为主,其次为革兰阳性球菌、真菌;前4位病原菌依次为大肠埃希菌(47.5%)、屎肠球菌(8.7%)、白色假丝酵母菌(7.0%)、肺炎克雷伯菌(6.5%);尿液直接涂片与培养的阳性率分别为51.9%、29.3%,结果符合率为77.4%;病原菌对亚胺培南、万古霉素、利奈唑胺的耐药率为0;产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为19.3%和34.5%;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和庆大霉素高耐株(HLGR)检出率分别为33.3%和58.2%。结论尿液直接细菌涂片、细菌培养及药敏试验可为临床合理应用抗菌药物提供依据。

OBJECTIVE To understand the distribution and the drug resistance of the pathogenic bacteria so as to guide rational application of antibiotics for clinics. METHODS Bacteria culture and drug sensitivity with urine specimen were done among 1513 cases with urinary tract infection. RESULTS Urinary infection was mostly due to Gram-negative bacilli. Gram-positive cocci and fungi were the second. The top four pathogens were Escherichia coli （47.5 % ）, Enterococcus f aecium （ 8. 7 % ）, Candida albicans （ 7.0 % ）, and K lebsiella pneumoniae （ 6. 5 % ）. The positive rates of urinary smear and culture were 51.9% and 29.3%, respectively with a coincidence rate of 77.4%. The drug resistance rates against imipenem, vancomycin and linezolid were zero, with 19.3% and 34.5% against extended-spectrum β-lactamases-producing E. coli （ESBLs） and K. pneumoniae together, with 33.3% and 58. 2% against meticillin-resistant coagulase negative Staphylococcus （MRCNS） and high-level gentamicin resistance（HLGR）. CONCLUSIONS Urinary smear, bacteria Culture and drug sensitivity tests can offer the basis for clinical rational use of antibiotics.