尿路感染病原菌分布及耐药性

Distribution and drug resistance of pathogens causing urinary tract infections

目的了解医院尿路感染病原菌分布及耐药性,为临床用药提供依据。方法按照常规培养方法分离病原菌,采用法国生物梅里埃公司API鉴定系统及K-B琼脂扩散法对病原菌进行鉴定及药物敏感试验,应用WHONET5.5软件分析病原菌分布及耐药性。结果 930株尿路感染主要病原菌中,革兰阴性杆菌574株占61.7%,革兰阳性球菌234株占25.2%,真菌122株占13.1%;耐甲氧西林金黄色葡萄球菌(MRSA)及耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别为8.5%、10.3%;大肠埃希菌及肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)检出率为19.8%、14.7%。结论大肠埃希菌是尿路感染的主要病原菌,真菌感染及细菌多药耐药是医院面临的重要问题,临床上应根据体外药敏结果选择抗菌药物,控制耐药菌株的产生。

OBJECTIVE To explore the distribution and drug resistance of the pathogens causing urinary tract infections so as to provide evidence for clinical application of antibiotics. METHODS The pathogens were isolated and identified by routine methods. The identification of the pathogens and the drug susceptibility testing were performed by Kirby-Bauer methods, and the distribution of the pathogens and the drug resistance were analyzed by WHONET5.5 software. RESULTS Of 930 strains of pathogens causing urinary tract infections, there were 574 （61.7 %） strains of gram-negative bacilli, 234 （25.2%） strains of gram-positive cocci, and 122 （13.1 %） strains of fungi; the detection rates of MRSA and MRCNS were 8. 5% and 10.3M, respectively; the detection rates of extended-spectrum 13-1actamases （ESBLs）-producing Escherichia coli and Klebsiella pneumoniae were 19.8% and 14.7%, respectively. CONCLUSION E. coli is the main pathogen causing urinary tract infections. The hospital faces the main problems like fungal infections and multidrug-resistance, it is necessary to control the drug resistant strains in accordance with in vitro drug susceptibility testing.