2011年我院尿培养结果及耐药性分析

Analysis of urine culture results and their drug resistance in our hospital in 2011

目的对我院2011年泌尿系感染的病人进行中段尿渡培养与药敏结果进行分析，找出常见感染菌和敏感药物，为临床泌尿道感染合理用药提供依据。方法留取中段尿或导尿，采用杭州微生物试剂厂的微量生药反应管对病原菌进行菌株鉴定，采用康奈生物科技有限公司的药敏试验板条进行药敏试验。结果214例泌尿系感染患者中92例（43％）中段尿培养呈阳性，革兰氏阴性杆菌4.4倒（47．83％），其中大肠埃希氏菌29倒（65．91％），产ESBL的大肠5例（17．24％）。革兰氏阳性球菌35例（38．04％）其中肠球菌17例（48．57％），金黄色葡萄球菌14例（4J0％）其中耐甲氧西林的金黄色葡萄球菌（MRSA）6例（42．86％），霉菌13例（14．13％）。阳性球菌，阴性杆菌耐药率均较高，其中肠球菌时克拉霉素，头孢菌素耐药为100％，与近年来的一些文献报导一致，为天然耐药菌，对万古霉素100％敏感。革兰氏阴性菌对哌拉西林，氨苄西林，环丙沙星及头孢类耐药率均较高，对泰能敏感率为100％。结论2011年来我院尿液培养阳性率较高，耐药性较强，金黄色葡萄球菌及MRSA＋以及霉菌的检出率有所增长，因此临床应严格控制滥用抗生隶，应根据药敏结果合理选用抗菌药物。

Objective To find out the common pathogenic bacteria and drug sensitivity of urinary tract infections, for providing clinical reasonable medication basis. Method Take the middle segment urine or catheterization, using Hangzhou microbiology, reagent factory of trace drug reaction tube on bacteria strains were identified, with Kang Nai biotechnology limited susceptibility test strip for drug sensitivity test. Re-suits 214 cases of urine, tract infection in 92 patients （43%） urine culture was positive, gram - negative bacilli in 44 cases （47.83%）, wherein the Escherichia coli in 29 eases （ 65.91% ）, ESBL E. in 5 cases （ 17.24 % ）. Gram - positive cocci in 35 cases （38.04 % ） of which 17 cases （48.57%）, enteococci, Staphylococcus aureus in 14 patients （40%） wherein the methicilhn-resistant Staphylococcus aureus （MRSA） in 6 patients （42.86%） mold in 13 cases （ 14.13% ） . cocci, bacilli of negative resistance rate higher, one of enterococci to clar-ithromycin, cephalosporin resistance in 100%, and in recent years some literature reports consistent, as one of 100% sensitive to vancomycin resistant bacteria, gram negative bacteria on piperacillin, ciprofioxacin and ampicillin, cephalosporin resistance rates were high, the company is seritive to the rate of 100 % . Conclusion the Institute recently urine culture positive rate, resistance is stronger, Staphyloctrccus aureus and MRSA ＋ and the detection ratio of fungi increased, therefore the clinical should strictly control the abuse of antibiotics, should be chosen ac- cording to antimicrobial susceptibility test results of antibacterial drugs.