496例尿路感染者尿培养结果及耐药性分析

Analyzsis on the urine culture and drug resistance of 496 cases with urinary tract infection

目的探讨分析尿路感染患者中段尿培养的结果及耐药性,便于指导临床用药。方法收集本院2012年1月至2013年1月收治的496例尿路感染者,进行了中段尿培养及药敏试验。结果入组496例尿路感染者细菌菌谱中革兰阴性菌(G-)为322株,构成比为64.92%,主要为大肠埃希菌152株(30.65%);革兰阳性菌(G+)为169株,构成比为34.07%,主要为粪肠球菌48株(9.68%)和屎肠球菌41株(8.27%);其中真菌感染为5株,构成比为1.01%。选取全部菌种中5类主要菌种进行药敏分析:大肠埃希菌、粪肠球菌、屎肠球菌、凝固酶阴性的葡萄球菌和铜绿假单胞菌,其中G+菌耐药率较高,其中屎肠球菌对于氨苄西林、头孢噻肟、环丙沙星、庆大霉素等抗菌药物的耐药率为100%;凝固酶阴性的葡萄球菌对氨苄西林、头孢噻肟、环丙沙星的耐药率均为100%,对庆大霉素的耐药率为68.57%。结论尿路感染者以革兰阴性菌感染为主,但革兰阳性菌对常规抗菌药物耐药率较高,便于指导临床应用抗菌药物。

Objective To investigate the urine culture results and antibiotic resistance in patients with urinary tract infection, and to guide the application of the clinical medicine.Methods From January 2012 to January 2013, total of 496 cases with urinary tract infection accepted urine culture and sensitivity test.Result Among the 496 cases with urinary tract infection, Gram-negative bacteria （G-） were 322 strains, the constituent ratio was 64.92%, mainly wasE. coli （152 strains, 30.65%）; Gram-positive bacteria （G＋） were 169 strains （34.07%）, the mainly wasEnterococcus faecalis（48 strains, 9.68%） andEnterococcus feces （41 strains, 8.27%）. The fungal infection were 5 strains （1.01%）.Escherichia coli,Enterococcus faecalis,Enterococcus feces, coagulase-negativeStaphylococci andPseudomonas aeruginosa were selected to sensitivity analysis, the result showed that the G＋ had higher resistance rates. TheEnterococcus had a 100%resistance rate to ampicillin, cefotaxime, ciprolfoxacin and gentamicin. The coagulase-negativeStaphylococci had a resistance rate of 100% to ampicillin, cefotaxime, ciprolfoxacin, and it had a resistance rate of 68.57%to gentamicin.Conclusions Urinary tract infection is mainly Gram-negative bacterial infections, but Gram-positive bacteria resistant to conventional antibiotics, with a higher rate, easy to guide the clinical use of antibiotics.