泌尿系感染病原菌的分布及耐药性分析

Analysis of drug resistance and distribution of pathogens causing urinary infection

目的了解泌尿系感染患者的病原菌的分布及耐药性,为临床提供可靠的诊断和治疗依据。方法对从尿液标本中分离出的720株(其中男性200株,女性520株)病原菌用美国德灵公司Mi-cro Scanauto SCAN4型微生物全自动分析仪进行细菌鉴定和药敏试验。结果分离前5位的细菌依次为大肠埃希菌(58.2%),变形杆菌(12.5%),凝固酶阴性葡萄球菌(9.3%),肺炎克雷伯菌(8.8%),铜绿假单胞菌(7.2%),革兰阴性杆菌对亚胺培南、头孢哌酮/舒巴坦、阿米卡星敏感性较好(>70%),对其他抗生素耐药率呈上升趋势;革兰阳性球菌对青霉素类、喹诺酮类、大环内酯类、复方新诺明耐药率较高,仅万古霉素敏感率为100%。结论大肠埃希菌为泌尿系感染的主要病原菌(占58.2%)。女性患者明显高于男性患者;用于病原菌耐药性呈上升趋势,临床医师应根据尿液培养结果合理选用抗菌药物。

Objective To find out the drug resistance and distribution of pathogens causing urinary Infection and provide the bases for diagnosis and therapy.Methods Among the 720 strain pathogens isolated from urine specimen,200 patients were male and 520 patients were female.The Micro ScanAuto SCAN analyser made by Dade Behring Inc.（USA） was used to identify pathogens and drug sensitivity tests.Results Rounding out the Top 5 were Escherichia coli 58.2%,Proteus species 12.5%,Coagulase-negative Staphylococcus 9.3%,klebsielia pneumoniae 8.8%,Pseudomonas aeruginosa 7.2%.Imipenem,cefoperazone/sulbactam and Amikacin were sensitive to gram-negative bacterium;But the resistance of other antibiotic showed ascending tendency.The resistance rate of gram-positive cocci was relatively highly to penicillins,quinolones,macrolides and Sinomin Compositea;But Vancomycin was sensitive to gram-positive cocci.Conclusion Escherichia coli （58.2%）is the main pathogens causing urinary infection.The female Patients are more than the male patients in the urinary infection.The drug resistance of pathogens shows ascending tendency,so the clinicians should use the antibacterials rationally according to the results of drug sensitivity tests about pathogens causing urinary infection.