肾内科患者尿路感染病原菌分布与耐药性分析

Analysis on distribution and drug resistance of pathogenic bacteria in patients with urinary tract infection of nephrology department

目的分析肾内科患者尿路感染病原菌分布及耐药性,以指导临床合理用药。方法回顾性分析医院2012年1月-2013年12月肾内科302例尿路感染患者临床资料,统计分析其感染的病原菌种类分布及病原菌药敏试验结果,采用法国生物梅里埃公司生产的VITEK-32全自动细菌鉴定仪进行细菌鉴定及药敏试验。结果尿路感染患者标本中共分离出154株病原菌,其中革兰阴性菌110株占71.43%,以大肠埃希菌和铜绿假单胞菌为主,分别占20.78%和19.48%,革兰阳性菌28株占18.18%,以粪肠球菌为主占9.74%,真菌16株占10.39%,以白色假丝酵母菌为主占7.14%;大肠埃希菌和铜绿假单胞菌对亚胺培南的耐药率较低,分别为0、13.33%,粪肠球菌对磺胺甲噁唑/甲氧苄啶耐药率较低为20.00%。结论肾内科患者泌尿道感染病原菌以革兰阴性菌为主,其中大肠埃希菌为尿路感染的主要病原菌,其耐药性呈上升趋势,临床上应根据病原菌药敏结果合理使用抗菌药物。

OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in patients with urinary tract infection of nephrology department, so as to instruct reasonable use of drugs for clinical treatment. METHODS A total of 302 patients with urinary tract infection in the hospital from Jan. 2012 to Dec. 2013 were retrospectively analyzed. The results of distribution and proportion of pathogenic bacteria, and drug sensitive test were analyzed by VITEK-32 automatic bacteria identification produced by BioMerieux. RESULTS Totally 154 strains of pathogenic bacteria were isolated from the samples of patients with urinary tract infection. Among them, 110 strains of gram- negative bacteria accounted for 71.43%, the predominant pathogens were Escherichia coli （20.78%）and Pseudomonas aeruginosa （19.48%）% gram-positive bacteria（28 strains） accounted for 18. 18%, among them, the predominant pathogens were Enterococcus faecalis （9.74%）% fungi（16 strains） accounted for 10.39% ,the predominant pathogens were Ca%ndida albicans（7.14%）. The drug resistance rate of E. coli and P. aeruginosa to imipenem was low, at a level of 0 and 13, 33% respectively. The drug resistance rate of E. faecalis to sulfamethoxazole/trimethoprim was 20. 00%, which was also at a low level. CONCLUSION Gram%negative bacteria are the main pathogens in urinary tract infections and E. coli hold a majority. The drug resistance rate is on the rise. Antibiotics should be reasonably used in clinic according to results of pathogen susceptibility test.