医院获得性尿路感染病原菌的耐药性分析

Drug resistance of pathogens causing hospital-acquired urinary tract infection

目的探讨医院获得性尿路感染病原菌的耐药性,为临床医师预防与控制尿路感染提供试验依据。方法对医院185例医院获得性尿路感染患者的病原菌进行鉴定及药敏试验,细菌培养按照《全国临床检验操作规程》进行;采用法国生物梅里埃公司VITEK-32全自动微生物分析仪鉴定菌株;采用K-B法进行药敏试验,结果按CLSI折点进行评价。结果 185株尿路感染病原菌中以大肠埃希菌为主,占38.9%;肠球菌属第2位,占16.2%;金黄色葡萄球菌第3位,占15.1%;革兰阴性杆菌对碳青霉烯类抗菌药物100.0%敏感;革兰阳性球菌对糖肽类抗菌药物100.0%敏感;但对其他常用抗菌药物均产生了较大的耐药性。结论医院获得性尿路感染的治疗应严格按照药敏试验结果选择用药,才能获得较好的临床治愈率。

OBJECTIVE To approach the antimicrobial resistance of pathogenic bacteria in nosocomial urinary tract infection and offer experimental evidence for clinical prevention and controlling of it.METHODS Pathogenic bacteria isolated from 185 cases of urinary tract infections specimens were covered in this study.Bacterial culturation was performed according to National Guide to Clinical Laboratory Procedures.The VITEK-32 identification system（France bioMérieux） was used to identify the strains.The susceptibility testing was performed by K-B methods.And susceptibility testing results were assessed according to CLSI breakpoints.RESULTS Among 185 strains of pathogenic bacteria,Escherichia coli（38.9%） ranked the top one,followed by enterococcus（16.2%） and Staphylococcus aureus（15.1%）.The higher resistance to commonly used antibiotics occurred except for 100.0% of Gram-negative bacilli sensitive to carbapenem antibiotics and 100.0% of Gram-positive cocci sensitive to glycopeptide antibiotics.CONCLUSIONS The clinician should treat nosocomial urinary tract infection according to susceptibility testing results.