医院住院患者泌尿系感染病原菌分布及耐药性分析

Distribution and drug resistance surveillance of urinary system infection in hospital

目的了解医院泌尿系感染患者病原菌的分布及其耐药率,为临床用药提供依据。方法对2011年1月至2014年12月新乡医学院第一附属医院住院的泌尿感染患者的病原菌分布及耐药率进行回顾性分析。结果829株病原菌中革兰阴性菌560株（67.5%）,革兰阳性菌179株（21.6%）,真菌90株（10.9%）;革兰阴性菌以大肠埃希菌为主（49.7%,412/829）,革兰阳性菌以肠球菌属为主（9.9%,82/829）,真菌以白色念珠菌为主（7.5%,62/829）。大肠埃希菌产超广谱β2内酰胺酶（ESBLs）的阳性率为34.5%-39.2%。大肠埃希菌对氨苄西林耐药率最高,均大于90.0%,对亚胺培南耐药率最低（0.4%-0.6%）。屎肠球菌对庆大霉素的耐药率为65.7%-66.2%,对利奈唑胺的耐药率为0.0%。白色念珠菌对两性霉素B的耐药率为2.4%-3.1%。结论泌尿系感染的病原菌分布广泛,临床医生应重视细菌学培养,以药物敏感性试验结果指导临床合理用药。

Objective To investigate the constituent ratio and drug-resistance of pathogens causing urinary tract infections in patients and offer evidence for reasonable use of antibiotics for anti-infective treatment. Methods The distribution and drug resistance of pathogens isolated from patients during January 2011 to December 2014 were retrospectively analyzed. Results Eight hundred and twenty-nine strains of pathogenic bacteria in gram negative bacteria（ 560 strains） accounted for67. 5%,gram positive bacteria（ 179 strains） accounted for 21. 6% and fungi（ 90 strains） accounted for 10. 9%. E. coli was mainly in gram negative bacteria,and enterococcus genera in gram positive bacterium. E. coli（ 412 strains） accounted for49. 7% of the total; candida albicans（ 62 strains） accounted for 7. 5%; excrement enterococcus accounted for 4. 0%,respectively. The positive rate of producing ultra broad spectrum beta 2 lactamase（ ESBLs） in E. coli was 34. 5% - 39. 2%. The drug resistance rate of E. coli to ampicillin was the highest（ 90. 0%）,while it was the lowest to imipenem（ 0. 4%- 0. 6%）. The drug resistance rate of Enterococcus faecium to gentamicin was 65. 7%- 66. 2%,while it was 0. 0% to linezolid. The drug resistance rate of Candida albicans to amphotericin B was 2. 4%- 3. 1%. Conclusion Pathogenic bacteria of urinary tract infections distribute widely. It is recommended that the clinician should choose the suitable drug with high sensitivity for anti-infective therapy based on etiological detection and drug susceptibility data.