1042例尿路感染致病菌分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria in 1042 cases with urinary tract infection

目的研究泌尿系统感染常见致病菌的分布及耐药情况,指导临床合理使用抗菌药物。方法回顾性分析2013~2015年该院泌尿外科住院病历,对泌尿感染患者的细菌培养及药敏结果进行统计分析。结果共检出1 042株致病菌,革兰阴性菌占总细菌数的79.0%,革兰阳性菌占15.3%,真菌占5.7%。其中革兰阴性菌以大肠埃希菌为主,革兰阳性菌以肠球菌属为主。革兰阴性菌对于头孢曲松、头孢噻肟、左氧氟沙星、复方磺胺甲噁唑、环丙沙星、氨曲南、头孢吡肟耐药率均比较高,对于哌拉西林-他唑巴坦、亚胺培南的耐药率低于6.0%;革兰阳性菌对万古霉素、利奈唑胺、呋喃妥因均较敏感,对克林霉素、红霉素、头孢曲松的耐药率较高（〉70.0%）。结论临床在选择抗菌药物时应充分结合细菌培养及药敏结果,合理使用抗菌药物。

Objective To analyze the distribution and drug resistance of pathogenic bacteria in patients with urinary tract infection,and to provide evidence for clinical application of antibiotics.Methods Records of patients with urinary tract infection in the hospital from January 2013 to December 2015 in the department of urinary surgery were selected and analyzed retrospectively.The drug resistance test was performed and the results were statistically analyzed.Results A total of 1 042 strains of the bacteria were isolated in 3years.Gram-negative bacilli were the most common pathogen in urinary tract infection,which accounted for 79.0%.And gram-positive bacilli accounted for 15.3%,and fungi accounted for 5.7%.Escherichia coli were the most common gram-negative bacilli.Enterococcus bacteria were the predominant pathogen of gram-positive bacteria.Candida albicans were the predominant pathogen of fungi.The rates of drug resistance of Gram-negative bacilli for ceftriaxone,cefotaxime,levofloxacin,trimethoprim/sulfamethoxazole,ciprofloxacin,aztreonam and cefepime were higher.And the rates of drug resistance of Gram-negative bacilli for piperacillin/tazobactam and imipenem were lower than 6.0%.Gram-positive bacilli were found to be sensitive to vancomycinl,inezolid and nitrofurantoin,and the rates of drug resistance of Gram-positive bacilli for clindamycin,erythromycin and ceftriaxone were higher than 70.0%.Conclusion Escherichia coli are still the main pathogens of urinary tract infections.Clinical use of antibiotics should be combined of the results of bacterial culture and drug sensitivity.