尿路感染病原菌分布及大肠埃希菌的耐药性分析

The Distribution of Causative Bacteria and Drug Resistance of Escherichia Coli in Urinary Tract Infection

目的:了解保山某院尿路感染病原菌的分布情况及大肠埃希菌的耐药情况,为临床合理使用抗生素提供依据。方法:用VITET-2 Compact60全自动微生物分析仪鉴定细菌,K-B纸片扩散法做体外药敏试验,统计、分析细菌的检出率和药敏结果。结果:尿路感染病原菌占第一位的是大肠埃希菌(74.2%),其次为肺炎克雷伯菌(10%),次之为表皮葡萄球菌(4.3%);病原菌在临床各科室分布情况为泌尿科45.7%、康复科20%、ICU 14.3%;52株大肠埃希菌对13种抗生素的耐药率居前三位的分别为:氨苄西林98%、复方新诺明76.9%、庆大霉素65.4%,52株大肠埃希菌对厄他培南、亚胺培南均敏感;52株大肠埃希菌中产ESBLs的29株占55.8%,非产ESBLs的23株占44.2%。结论:医院尿路感染病原菌以大肠埃希菌为主,科室分布以泌尿科为首,尿路感染大肠埃希菌的耐药情况较严重,医院应加强其耐药性监测,医生应依据体外药敏试验结果合理选择抗生素。

Objective： To understand the distribution of causative organisms in urinary tract infection and drug resistance of Escherichia coli in a hospital located in Baoshan in order to provide clinicians the basis for rational use of antibiotics. Methods： The identification of bacteria and susceptibility test were performed by using automatic bioanalysis- VITET-2 Compact 60 and Kirby-Bauer methods; the detection rate and the drug sensitivity results of bacterial were analyzed statistically. Results： The first three detection rates of causative bacteria in urine samples were： Escherichia coli topped （74.2%）, Klebsiellapneumoniae followed （10%）, Staphylococcus epidermidis was third （4.3%）. The detection rates of causative bacteria in the top three clinical departments were： department of urology 45.7%, department of rehabilitation 20%, ICU 14.3%. The top three drug resistance rates of 52 strains of Escherichia coli to 13 kinds of antibiotics were： ampicillin 98%, cotrimoxazole 76.9%, gentamicin 65.4%. All the strains of Escherichia coli were sensitive to ertapenem and imipenem; 29 cases of ESBL-producing Escherichia coli accounted for 55.8%, 23 cases of non ESBL-producing ones accounted for 44.2%. Conclusion： Escherichia coli are in the majority of urinary tract infections caused by organisms in hospital. The infectious cases in urinary department are first in the distribution of clinical departments. Since the drug resistance of Escherichia coli in urinary tract infection is serious, the hospital should strengthen monitoring of drug resistance of Escherichia coli and doctors should select antibiotics based on the results of drug sensitivity test in vitro.