重症医学科尿液分离菌及其耐药性变迁

INVESTIGATION ON BACTERIA ISOLATED FROM URINE AND CHANGES OF THEIR DRUG RESISTANCE IN ICU

目的了解医院重症医学科尿液分离菌及其对抗生素耐药性的变迁,为加强医院感染控制措施提供依据。方法采用回顾性调查和药敏试验方法,对2008-2010年本医院重症医学科住院患者尿液标本中分离的致病菌情况进行了调查。结果该医院重症医学科在3年期间共从病人尿液标本中检测到916株细菌,其中革兰阴性菌345株,占37.66%;革兰阳性菌254株,占27.73%;各类真菌317株,占34.61%。检出的主要菌株为大肠埃希菌、热带假丝酵母菌、屎肠球菌(D群)。检出的革兰阳性菌中以肠球菌为主。这些菌株对多数临床使用中抗生素具有不同程度耐药,但耐药率在连续3年监测数据中未发现明显上升趋势。结论该医院重症医学科病人尿液中分离菌株以大肠埃希菌和真菌为主,居前三位依次是大肠埃希菌、热带假丝酵母菌和屎肠球菌(D群)。在近三年期间尿路感染致病菌对常用抗尿路感染药物多数耐药,但耐药率上升不明显。

Objective To investigate the bacteria isolated from urine and changes of their drug resistance in order to provide basis for strengthening the hospital infection control measures.Methods The retrospective survey and drug sensitivity test were used to investigate the pathogenic bacteria isolated from urine of the patients in ICU in our hospital during 2008 to 2010.Results Totally 916 strains of bacteria were detected from the patients＇ urine samples in these three years in the ICU,including 345 gram-negative bacteria that accounting for 37.66%,254 gram-positive bacteria that accounting for 27.73% and 317 strains of fungi of different types that accounting for 34.61%.Strains detected were mainly Escherichia coli,Candida tropicalis bacteria and Enterococcus faecium（Group D）.The gram-positive bacteria detected were mainly enterococcus faecium.Most of these strains were resistant to the most antibiotics in clinical use with different degrees.But the rate of drug-resistant was not found a clear upward trend within the data detected in the three consecutive years.Conclusion The bacteria isolated from the patients＇ urine in the ICU are mainly Escherichia coli and fungi.The first three types are Escherichia coli,Candida tropicalis bacteria and Enterococcus faecium（Group D）.In the past three years,urinary tract infection pathogens have resistance to the common drug for this disease mostly.However,the resistance rates have not increased obviously.