围产期生殖道感染病原菌构成与耐药性分析

Distribution and drug resistance of pathogens causing perinatal genital tract infections

目的探析围产期生殖道感染病原菌构成特点及其耐药性,为临床合理用药提供参考。方法收集医院2011年1月-2014年1月围产期生殖道感染患者送检标本2 040份,对标本进行病原学检测及药敏试验,统计感染病原菌分布及其耐药性;使用SPSS17.0软件进行统计分析。结果 2 040份送检标本中共检出病原菌90株,阳性检出率为4.4%,其中革兰阳性菌37株占41.1%,以金黄色葡萄球菌和链球菌属为主,革兰阴性菌53株占58.9%,以大肠埃希菌、肺炎克雷伯菌为主;24株金黄色葡萄球菌中MRSA检出6株,对青霉素耐药率最高,为70.8%,对阿米卡星、利福平、呋喃妥因、万古霉素高度敏感,耐药率<5.0%,链球菌属对红霉素的耐药率最高,为88.9%,对美罗培南、克拉维酸/阿莫西林高度敏感,耐药率为0;53株革兰阴性菌对氨苄西林/舒巴坦耐药率最高,为30.2%,对亚胺培南的耐药率为0。结论对围产期生殖道感染患者予以病原学检测,了解其耐药趋势及病原菌构成,对降低围产期生殖道感染率、降低耐药菌株产生、合理选择抗菌药物、控制医源性流行及感染暴发具有重要的临床意义。

OBJECTIVE To explore the distribution and drug resistance of the pathogens causing perinatal genital tract infections so as to provide guidance for reasonable clinical use of antibiotics .METHODS From Jan 2011 to Jan 2014 ,a total of 2 040 submitted specimens were collected from the patients with perinatal genital tract infections , then the etiological examination of the specimens and the drug susceptibility testing were performed ,the distribu‐tion and drug resistance of the pathogens causing infections were carried on statistics ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS Totally 90 strains of pathogens have been isolated from the 2 040 submitted specimens with the positive detection rate of 4 .4% ,including 37 （41 .1% ） strains of gram‐positive bacteria and 53 （58 .9% ） strains of gram‐negative bacteria;the Staphylococcus aureus and Strepto‐coccus spp were dominant among the gram‐positive bacteria;the Escherichiacoli and Klebsiella pneumoniae were the predominant species of gram‐negative bacteria .Among the 24 strains of S .aureus ,6 strains of MRSA were de‐tected ,the drug resistance rate to penicillin was the highest （70 .8% ） ,and the drug resistance rates to amikacin , rifampicin ,nitrofurantoin ,and vancomycin were less than 5 .0% ;the drug resistance rate of the Streptococcus spp to erythromycin was the highest （88 .9% ） ,and the drug resistance rates to meropenem and clavulanic acid‐amoxi‐cillin were 0 .The drug resistance rates of the 53 strains of gram‐negative bacteria to ampicillin‐sulbactam was the highest （30 .2% ） ,and the drug resistance rate to imipenem was 0 .CONCLUSION It is of great clinical significance to conduct the etiological examination for the patients with perinatal genital tract infections and understand the trend of drug resistance and the distribution of pathogens so as to reduce the incidence of the perinatal genital tract infections ,reduce the drug‐resistant strains ,reasonably use antibiotics ,and control the iatrogenic prevalence and outbreak of the infections .