尿路感染患者检出病原菌及其耐药情况分析

Urine culture of urinary tract infection patients and the drug resistance analysis

目的了解我院门诊与住院治疗泌尿系感染患者病原菌分布及其对常用抗菌药物的耐药情况，为临床合理应用抗生素提供依据。方法收集我院2005～2007年门诊及住院泌尿系感染患者尿培养检测的病原菌，采用Vitek32细菌分析系统进行鉴定和药敏试验。结果2005年1月至2007年12月共检出869株病原菌中，革兰阳性菌224株（25．78％），革兰阴性菌645株（74．22％）。检出病原菌前5位的依次为大肠埃希菌431株（49．60％），真菌91株（10．48％），肺炎克雷伯菌80株（9．21％），葡萄球菌属61株（7．02％），肠球菌属61株（7．02％）。还有的病原菌依次为铜绿假单胞菌31株（3．57％），奇异变形杆菌25株（2．88％），阴沟肠杆菌21株（2．42％），醋酸钙不动杆菌19株（2．19％）。其它菌49株（5．61％），除真菌外革兰阳性菌对万古霉素最敏感，革兰阴性菌较敏感药物为亚胺培南。结论临床应根据药敏试验结果合理选用抗菌药物。

Objective To investigate the out-patient clinic and inpatient care patients＇ pathogenic bacteria distribution of urinary tract infection and the drug resistance status, and provide the basis for the reasonable administration of antibiotics. Methods Collect the pathogenic bacteria of urinary tract infection patients between 2005 and 2007, and use the Vitek32 bacterium analytical system to identify and test susceptibility. Results Out of 869 pathogenic bacteria between January 2005 and December 2007, 224 cases were Gram-positive （25.78%） and 645 cases as Gram-negative （74.22%）, which is further detailed as 431 cases for Escherichia coli （49.60%）, 91 for fungus （10.48%）, 80 for Klebsiella pneumoniae （9.21%）, 61 for staphylococci （7.02%）, 61 for enterococci （7.02%）, 31 for Pseudomonas aeruginosa （3.57%）, 25 for Proteus mirabilis （2.88%）, 21 for Enterobacter cloacae （2.42%）, 19 for Acinetobacter calcoaceticus （2.19%）. Gram-positive bacteria were sensitive to vancomycin while Gram-negative bacteria were sensitive to imipenem. Conclusions Antibacterials should be chosen according to the susceptibility test results.