尿路感染常见病原菌及耐药性分析

PATHOGENIC BACTERIA IN URINARY TRACT INFECTION AND DRUG RESISTANCE ANALYSIS

目的了解本院尿路感染病人病原菌分布情况,为临床合理治疗提供依据。方法 2008年1月—2012年12月,我院确诊并有完整病原学资料的尿路感染病人共1 205例,对其尿液的病原学、药敏学进行分析。结果在1 205株病原菌中革兰阴性杆菌829株(68.80%),其中最多的是大肠埃希菌602株(49.96%),其次是肺炎克雷伯菌41株(3.40%)和铜绿假单胞菌40株(3.32%)。革兰阳性菌305株(25.31%),其中最多的是粪肠球菌103株(8.55%),其次是屎肠球菌68株(5.64%)和溶血葡萄球菌36株(2.99%)。另检出真菌71株(5.89%),以酵母菌为主。革兰阴性菌敏感性较高的抗生素依次为碳青酶烯类、耐酶青霉素、丁胺卡那霉素、头孢西丁。革兰阳性菌敏感性较高的抗生素为利奈唑胺、万古霉素、氧哌嗪青霉素/Tazo。结论尿路感染病人细菌耐药率较高,需根据病原菌的药敏试验选择用药,经验用药也要考虑不同地区、不同医院耐药率的差异。

Objective To understand the distribution of pathogenic bacteria isolated from patients with urinary tract in- fection （UTI） in our hospital, and provide a reference for clinical treatment. Methods From Jan. 2008 to Dec. 2012, 1 205 pa- tients with UTI who had complete etiologic information were enrolled. The urine etiology and drug sensitivity were analyzed. Re- sults Of 1 205 strains, 829 （68.80%） were gram-negative bacilli：602 （49.96%） were Escherichia coli, followed by 41 （3.40%） of Klebsiella pneumoniae and 40 （3.32 %） of Pseudomonas aeruginosa. Gram-positive bacteria were noted 305 （25.31%） strains： of which, the most were Enterococcus faecalis,103 （8.55%） strains, followed by Enterococcus feces, 68 （5.64%） strains, and Sta- phylococcus bacteria, 36 （2.99%） strains. Fungi were detected in 71 （5.89%） strains, mainly yeasts. The gram-negative bacteria were sensitive to carbapenems, penicillinase-fast penicillin, and cefoxitin; Gram positive bacteria were sensitive to linezolid, vanco- mycin, and piperacillin. Conclusion The bacterial resistance rate is high in patients with urinary tract infections. The medication should be based on drug sensitive tests. Empirical medication should also consider the differences of drug resistance between differ- ent areas and different hospitals.