留置导尿管尿液分离病原菌及其药敏结果分析

Isolation of pathogens in urine from indwelling catheters and analysis of the drug sensitivity of those pathogens

目的了解留置导尿管尿液分离菌群及其对抗生素的耐药性,以采取措施减少医院感染。方法回顾性分析2010年2月～2012年8月医院846例行留置导尿治疗患者尿液分离菌及药敏试验结果。结果 846例患者的尿液中分离出病原菌249株,阳性率为29.43%,其中革兰阴性菌最为多见,为134株(占53.82%),革兰阳性菌102株(占40.96%),真菌13株(占5.22%)。大肠埃希菌菌株数最多,80株(占32.13%),其次为金黄葡萄球菌,54株(占21.69%)。大肠埃希菌对环丙沙星耐药率最高,达90.67%,对头孢他啶、阿莫西林及左氧氟沙星耐药率也较高,对氨苄西林和氨曲南耐药率仅为8.84%,未发现耐亚胺培南菌株。肠球菌和葡萄球菌对头孢唑林100%耐药。结论留置导尿尿液分离病原菌以大肠埃希菌为最常见,其次为金黄葡萄球菌。合理使用各种侵袭性诊疗技术及抗生素对有效控制泌尿感染和避免耐药菌组的产生尤为重要。

Objective To isolate pathogens in urine from indwelling catheters and determine their resistance to antibiot ics in order to reduce nosocomial infection. Methods Pathogens isolated from urine specimens from 846 patients with an indwelling catheter from February 2010 to August 2012 were retrospectively analyzed and these pathogens were subjec- ted to a drug sensitivity testing. Results Two hundred and forty nine strains of microbes were detected in urine speci- mens from 846 patients. Of the specimens, 29.43~ tested positive. Gram-negative bacteria were the most prevalent mi- crobes, accounting for 134 strains （53.82~）. Gram-positive bacteria accounted for 102 strains （40.96~） and fungi ac- counted for 13 strains （5.22 ~ ）. Escherichia coli was the most prevalent bacteria, accounting for 80 strains （32.13）, and was followed by Staphylococcus aureus, which accounted for 54 strains （21.69 ~）. E. coli was most resistant to cipro floxacin （resistance of up to 90.67 ~）, and it was also highly resistant to eeftazidime, amoxicillin and levofloxacin. Its re- sistance to arupieillin and aztreonam was only 8.84o//oo, and no imipenem-resistant strains were noted. Enterococci and Staphylococci had 100~ resistance to cefazolin. Conclusion E. coli was the most prevalent pathogen in urine from in dwelling catheters, followed by S. aureus. Rational use o{ antibiotics and rational use of invasive techniques are crucial to the effective control of urinary tract infections and avoidance of the emergence of resistant strains.