泌尿道感染患者尿培养病原菌分布及耐药性调查

Investigation on the distribution of pathogens from urinary tract infection patients' urine and drug resistance

目的了解泌尿道感染患者中段尿培养病原菌种类及其耐药性,以指导临床合理使用抗菌药物。方法采用细菌分离培养和药敏试验方法,对某医院住院患者送检尿液标本进行检测与分析。结果在2014年全年门诊和住院患者共送检中段尿培养标本2 968例,病原菌培养阳性852例,阳性率28.7%。在检出的病原菌中,革兰阴性杆菌构成比为57.04%、革兰阳性球菌为27.82%和真菌15.14%。居前3位的病原菌分别是大肠埃希菌、粪肠球菌和腐殖隐球菌,构成比依次为41.43%、12.68%和7.39%。尿液分离出的大肠埃希菌几乎对所有抗菌药物都不同程度耐药,仅对亚胺培南较敏感;粪肠球菌除呋喃妥因之外全部耐药;真菌对常用抗真菌药物均比较敏感。结论该院尿路感染的致病菌以革兰阴性菌为主导,真菌感染比例也较高,除真菌外的病原菌普遍耐药。

Objective To know the kinds of pathogens from urinary tract infection urine culture and the drug resistance,in order to guide clinical rational use of antibiotics. Methods Bacterial culture and isolation and sensitivity test method were used to test and analysis the urine samples of hospital patient. Methods In 2014,2968 cases of outpatient and inpatient submitted urine specimen culture,852 cases were positive in pathogens culture,the positive rate was 28. 7%. Of the patho-genic bacteria,Gram-negative bacteria accounted for more than 57. 04%,Gram-positive cocci accounted for 27. 82% and 15. 14% was fungi. The top three pathogens were Escherichia coli,Enterococcus faecalis and humic Cryptococcus,the constit-uent ratio were 41. 43%,12. 68% and 7. 39% respectively. Escherichia coli isolated from the urine nearly resisted to all an-tibacterial agents with vary degrees,only sensitive to imipenem. Enterococcus faecalis resisted to all antibiotics except nitro-furantoin. Fungus were sensitive to commonly used antifungal drugs. Conclusion Gram-negative bacteria has predominate in hospital urinary tract infection,fungi infections has a high proportion too. And the pathogens are commonly resist to anti-biotics except fungi.