肾病患者尿培养阳性菌种分布及耐药性分析

Species distribution and drug resistance analysis of urine cultured positive strains in patients with nephropathy

目的分析本院近一年多以来肾病患者和泌尿系感染者的尿培养菌分布和耐药情况,为临床合理用药提供依据。方法采用回顾性查询,对2011年1月1日-2012年3月31日肾病中心和泌尿外科病区送检分离的菌株分析研究。结果共分离73例致病菌,其中革兰阴性杆菌56例(76.7%),以大肠埃希菌为主,共计41例(56.16%),各种革兰阴性杆菌检出率差异具有统计学意义(χ2=72,P<0.05);革兰阳性球菌13例(17.8%),以肠球菌为主,共计6例(8.22%),各种革兰阳性球菌检出率差异具有统计学意义(χ2=42,P<0.05);真菌4例(5.5%)。革兰阴性杆菌耐药率最低的是亚胺培南,最高的是氨苄西林,各种抗生素耐药率差异具有统计学意义(χ2=251.82,P<0.05);革兰阳性球菌中耐药率最低的是万古霉素,最高的是克林霉素,各种抗生素耐药率差异具有统计学意义(χ2=186.89,P<0.05)。结论尿培养对肾病患者极为重要,关系到临床用药和治疗方案的选择,应引起临床足够的重视。

Objective To analyze the species distribution and drug resistance of urine cultured positive strains in patients with nephropathy and urinary system infection in our hospital in the past year and provide evidence for clinical rational drug use.Methods By retrospective inquiry,the isolated strains submitted by kidney center and department of urology between January1,2011 and March 31,2012 were analyzed. Results A total of 73 cases of pathogens were isolated,including Gram negative bacilli in 56 cases（ 76. 7%）,a total of 41 Escherichia coli cases（ 56. 16%）,the detection rate of a variety of Gram negative bacilli has statistical significance（ χ^2= 72,P 〈0. 05）; 13 cases were Gram positive cocci,accounting for 17. 8%,a total of 6patients with Enterococcus（ 8. 22%）,the detection rate of a variety of Gram positive bacilli has statistical significance（ χ^2= 42,P 〈0. 05）; 4 cases were fungal（ 5. 5%）. Drug resistance of Gram negative bacilli to imipenem was the lowest,ampicillin was the highest,the difference of all kinds of antibiotic resistance rate had significant difference（ χ^2= 251. 82,P 〈0. 05）; the resistant rate of Gram positive coccus to Vancomycin was the lowest,the highest is Clindamycin,the difference of various antibiotic resistance rate is statistically significant（ χ^2= 186. 89,P 〈0. 05）. Conclusion Urine culture is extremely important for patients with nephropathy,which is related to the clinical medication and treatment options,and should cause clinical attention.