2198株尿液培养病原菌种类及耐药性分析

Distribution and drug resistance analysis of 2 198 pathogen isolated from urine

目的了解尿液培养病原菌种类及耐药性,为合理使用抗菌药物提供依据。方法细菌鉴定和药敏试验主要利用BD Phoenix100仪器。念珠菌利用显色平板分离和鉴定,K-B法药敏试验。数据分析用WHONET5.6软件。结果尿液中常见的病原菌有大肠埃希菌(39.5%)、粪肠球菌(9.1%)、肺炎克雷伯菌(6.0%)、屎肠球菌(5.7%)、白色念珠菌(5.1%)。大肠埃希菌产超广谱β-内酰胺酶(ESBLs)比例为48.6%,肺炎克雷伯菌产ESBLs比例分别为48.6%和53.4%。革兰阴性杆菌(G-杆菌)耐药率较低的为亚胺培南、美洛培南、阿米卡星、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦。葡萄球菌属甲氧西林耐药率为74.4%。革兰阳性球菌(G+球菌)对万古霉素、替考拉宁和利奈唑胺的敏感率均为100.0%。念珠菌对临床常用抗菌药物的耐药率均低于10.0%。结论尿液中分离病原菌耐药率较高,应加强抗菌药物的合理使用以降低耐药率。

Objective To investigate distribution and drug resistance of pathogen isolated from urine for using antibacterials reasonably. Methods Most bacteria isolates were identified with BD Phoenixl00. Candida isolates were identified by color display plate and drug sensitive test by K-B method. WHONET5.6 was applied for analysis. Re- sults The common isolates from urine were Escherichia coli（39. 5 %）, Enterococcus faecalis （9. 1%）, Klebsiella pneumoniae （ 6.0 % ）, Enterococcus faecium（ 5.7 % ）, Candida albicans （5.1% ）. The incidences of Escherichia coli and Klebsiella pneumoniae isolates producing extended spectrum beta--lactamase （ESBLs） were 48.6% and 53.4% respectively. In gram negative bacillus,lower durg resistance rate of antibaeterials were Imipenem. Meropenem, Amika- cin,（＇~efoperazone/Sulbactam,and Piperaeillin/Tazobactam. Drug resistance rate of methicillin resistant Staphylo- coccus was 74. 40/00. In gram positive coccus, sensitivity of Vaneomyein, Teicoplanin and Linezolid were 100. 0%. Candida drug resistance rate was less than 10.0% to clinical commonly used antimicrobials. Conclusion Drug resist- ance rate of pathogen isolated from urine in the hospital are high, it is important to enforce the rational use of antibac- terials for reducing the drug resistance rate.