我院肾内科2011-2013年住院患者尿路感染病原菌分布及耐药性分析

Distribution and Drug Resistance of Urinary Tract Infections Pathogens in the Inpatients from Nephrology Department of Our Hospital during 2011-2013

目的:了解我院肾内科住院患者尿路感染的病原菌分布特点及病原菌耐药现状,为临床选用抗菌药物提供参考。方法:对我院肾内科2011-2013年471例住院患者尿路感染的病原菌分布和抗菌药物耐药性进行回顾性分析。结果:471例患者中,3例为2种病原菌感染,1例为3种病原菌感染,分离出476株病原菌,其中革兰阴性(G-)菌301株(63.24%),革兰阳性(G+)菌136株(28.57%),真菌39株(8.19%)。产超广谱β-内酰胺酶(ESBLs)的阳性菌44株,占总菌株数的9.24%,占G-菌的14.62%;耐甲氧西林金黄色葡萄球菌(MRSA)24株,占总菌株数的5.04%,占G+菌的17.65%。对G+菌敏感性较高的药物有利奈唑胺和万古霉素等,对G-菌敏感性较高的药物有头孢哌酮/舒巴坦、亚胺培南和哌拉西林/他唑巴坦等。结论:我院肾内科住院患者尿路感染以G-菌为主,大肠埃希菌为主要致病菌,耐药性较高;敏感性较好的药物有头孢哌酮/舒巴坦、亚胺培南、哌拉西林/他唑巴坦、阿米卡星等。

OBJECTIVE： To investigate the distribution of urinary tract infection pathogens and their antibiotic resistance in the inpatients from nephrology department of our hospital, and to provide reference for strategic selection of antibiotics in the clinic. METHODS： Retrospective analysis was performed on the distribution and drug resistance of pathogenic bacteria in 471 inpatients with urinary tract infection from nephrology department during 2011-2013. RESULTS： A total of 476 strains （3 strains from one patient and another three patients have 2 strains respectively） were isolated from the 471 patients. There were 301 strains of Gram-negative bacilli （63.24%） as the main pathogenic bacteria, 136 strains of Gram-positive bacilli （28.57%o） and 39 strains of fungi （8.19%）. There were 44 strains of ESBLs positive bacteria accounting for 9.24% in the whole bacilli and 14.62% in Gram-negative bacilli, and 24 strain of MRSA accounting for 5.04% in the whole bacilli and 17.65% in Gram-positive bacilli. Linezolid and vancomycin have a good sensitivity to the Gram-positive bacilli, and cefoperazone/sulbactam, piperacillin/tazobactam and imipenem to the Gram-negative bacilli. CONCLUSIONS： The urinary tract infection pathogen is mainly Gram-negative bacilli in nephrology department of our hospital, of which Escherichia coli is the maximum one and resistance and sensitive to antibiotics as cefperazone/sulbactam, imipenem, piperacillin/tazobactam and amikacin.