医院内泌尿系感染病原菌及耐药性分析

Drug Resistance of Pathogens in Urinary Infection in Mountain Area Hospitals

目的调查医院内尿路感染病原菌的现状及体外耐药性，为临床提供科学诊断和治疗依据。方法对2006年7月～2008年6月门诊及住院患者尿液培养中分离出的168株病原菌进行鉴定和体外药物敏感试验。结果泌尿系感染以大肠埃希菌为主，占40．40％；肠杆菌科及革兰阳性球菌对抗菌药物耐药率均较严重，其中亚胺培南对革兰阴性杆菌作用最强，耐药率为0～10．00％；氨曲南、妥布霉素、阿米卡星、氨苄西林／舒巴坦也有较好的抗菌活性，其耐药率分别为0～70．00％、10．00％～30．88％、10．00％～57．14％、37．50％～64．71％；革兰阳性球菌对青霉素普遍耐药，其耐药率为57．69％～100．00％，万古霉素的耐药率为0。结论泌尿系感染最主要的病原菌是大肠埃希菌，耐药呈上升趋势，合理使用抗菌药物，进一步重视病原菌的培养和药敏，是预防医院感染的重要措施。

OBJECTIVE To summarize the present status and drug resistance of pathogens in hospital-acquired urinary infection, and provide diagnostic and evidence for clinic physician. METHODS A total of 168 pathogen strains in urinary infection from inpatients from Jul 2006 to Jun 2008 were identified and the drug resistance test was performed. RESULTS Escherichia coli was most common（40. 40%） in urinary infection, Enterobacter and Gram-positive cocci were with serious drug resistance. Inipenem was the most potent antimicrobial agents to the main Gram-negative bacilli, aztreonam, tobramyein, am[kacin and ampicillin/sulbactam also showed better susceptible. Gram-positive cocci were usually found resistant to penicillin and not resistant to vancomycin. CONCLUSIONS E. coli is the main bacteria in urinary infection. As the rate of drug resistance rises, rational use of antibiotics according to urine culture results and drug sensitivity test are the important way to prevent hospital infections.