579株泌尿道感染病原菌分布与耐药性分析

Distribution and antimicrobial resistance of 579 strains of pathogenic bacteria isolated from patients with a urinary tract infection

目的了解泌尿道感染的病原菌分布及其耐药情况。方法采用VITEK32细菌鉴定系统对2008年1月～2010年12月尿培养分离的579株病原菌进行鉴定,纸片扩散法做药敏试验。结果 579株病原菌以革兰阴性杆菌为主(404株),优势菌为大肠埃希菌(266株),占45.94%,其次为肺炎克雷伯菌(50株)和奇异变形杆菌(41株);革兰阳性菌(175株)的优势菌为屎肠球菌(87株)和粪肠球菌(73株)。产ESBL的大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌的检出率分别为53.00%、36.00%和36.59%。病原菌对各抗生素的耐药率不同,对多数抗生素的耐药率高于50%,对头孢哌酮钠/舒巴坦、哌拉西林/三唑巴坦、亚胺培南、美罗培南、阿米卡星以及万古霉素和替考拉宁等抗生素耐药率较低。结论泌尿道感染病原菌以大肠埃希菌为主;应根据药敏结果合理使用抗菌药物。

Objective To investigate the distribution and antimicrobial resistance of pathogenic bacteria responsible for urinary tract infections（UTIs）.Methods Five hundred and seventy-nine strains of pathogenic bacteria isolated from urine were identified by VITEK 32 from January 2008 to December 2010.Antimicrobial susceptibility testing was performed via a disk diffusion test,and the distribution and antimicrobial resistance of pathogenic bacteria was analyzed with WHONET 5.4.Results Among 579 strains of pathogenic bacteria,the most common was Gram-negative bacilli,the predominant strain of which was Escherichia coli（45.94%）.The predominant strains of Gram-positive bacteria were Enterococcus faecalis（12.6%） and Enterococcus faecium（15.0%）.The rate of ESBL-producing E.coli,Klebsiella pneumonia,and Proteus mirabilis was 53.00%,36.00%,and 36.59%.The antimicrobial resistance of these pathogenic bacteria differed.Resistance to most antibiotics was greater than 50%,although resistance to cefoperazone-sulbactam,piperacillin-tazobactam,imipenem,meropenem,amikacin,vancomycin,and teicoplanin was relatively low.Conclusion The predominant bacteria from UTIs were Gram-negative bacteria,the most common of which was E.coli.Antibiotics should be used based on results of susceptibility testing.