泌尿系感染的病原菌分布及大肠埃希菌耐药性分析

Analysis of pathogenic bacteria distribution and Escherichia coli drug resistance in urinary tract infection

目的通过对泌尿系感染(UTI)病原菌进行统计分析,了解其种属分布以及耐药性规律,为临床用药提供参考依据。方法对送检尿液标本中分离出的884株病原菌进行鉴定和药敏试验,并进行统计学分析。结果分离出的病原菌中主要为大肠埃希菌(578株),占总数的65.4%,肠球菌和肺炎克雷伯菌分别排在第2位和第3位。大肠埃希菌中超广谱β-内酰胺酶(ESBLs)阳性菌株384株,阳性率高达66.4%;其对亚胺培南、美罗培南、呋喃妥因、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星等抗菌药物的耐药率低于5.5%;对喹诺酮类抗菌药物的耐药率高于69%;对哌拉西林和氨苄西林的耐药率超过70%。结论 UTI患者感染的大肠埃希菌对常用的抗菌药物的耐药情况十分严峻,临床医生应当参考药敏结果,科学使用抗菌药物。

Objective To analyze the species distribution and drug resistance of pathogenic bacteria in urinary tract infection pa- tients, so as to provide evidence for the clinical diagnosis and the treatment of urinary tract infection. Methods 884 strains of pathogens were identified, and drug resistance was tested. The results were analyzed by WHONETS. 5 software. Results 578 strains of Escherichia coli accounted for 65.4% of all the pathogenics isolated. Escherichia coli was the most isolated pathogen, Enterococcus and Klebsiella pneumoniae were in the second and third row,respectively. There were 384 strains of Escherichia coli producing extended spectrum β-lactamases（ESBLs）, accounting for 66.4% of all. The drug resistance rates of Escherichia coli for imipenem, meropenem, nitrofurantoin, cefoperazone/sulbactam, piperacillin/tazobactam, and amikacin were less than 5.5%, and that for quinolones was over 69 %, for piperacillin and ampicillin were over 70%. Conclusion The situation of Escherichia coli in- fection is very serious in urinary tract infection patients. Doctors should choose antimicrobial drugs reasonably according to the drug resistance rates of pathogens.