泌尿外科住院患者中段尿培养病原菌分布及耐药性分析

Distribution and drug resistance of pathogens cultured in hospitalized patients of department of urology

目的 了解泌尿外科住院患者尿培养病原菌的分布和耐药性,为临床合理用药提供依据.方法 回顾性统计2014年1月至2015年6月本院泌尿外科患者中段尿培养的临床资料,进行耐药性分析.结果 泌尿外科共送检1624份尿标本,其中532份分离出病原菌,阳性率为32.76％.532份阳性标本共分离病原菌566株,其中革兰氏阴性杆菌449株,占79.33％,革兰氏阳性球菌93株,占16.43％,真菌24株,占4.24％.分离率居前五位的细菌分别是大肠埃希菌（53.53％）、屎肠球菌（5.65％）、铜绿假单胞菌（4.77％）、粪肠球菌（4.24％）、肺炎克雷伯菌（3.89％）.大肠埃希菌对头孢菌素类、喹诺酮类、四环素类、磺胺类药物均表现为较高的耐药率;屎肠球菌对氨苄西林、高浓度庆大霉素、喹诺酮类药物耐药率较高.结论 泌尿外科住院患者尿培养病原菌以大肠埃希菌为主,细菌耐药情况严重,加强尿培养监测及定期对细菌耐药性进行总结分析对指导临床规范、合理使用抗菌药物具有非常重要的意义.

Objectives To analyze the distribution and drug resistance of pathogens cultured in hospitalized patients of department of urology so as to provide scientific evidence forrational using of antibiotics in clinic.Methods Clincal data of urine culture and drug resistance of pathogens of inpatients in urology department from January 2014 to June 2015 in our hospital were retrospectively analyzed.Results A total of 1624 urine samples were tested,among them,532 pathogens were isolated and the positive rate was 32.76%.566 pathogenic bacteria strains were isolated from 532 positive samples,of which 499 gram-negative bacilli strains（79.33%）,93 gram-positive cocci strains （16.43%） and 24 fungal strains （4.24%）.Additionally,top 5 isolation rates of bacteria were Escherichia coil （53.53%）,Enterococcus faecium （5.65%）,Pseudomonas aeruginosa （4.77%）,Enterococcus faecalis （4.24%） and Klebsiella pneumoniae （3.89%）.Moreover,E.coli was highly resistant to cephalosporins,quinolones,tetracyclines and sulfonamides.E.faecium was highly resistant to ampicillin,gentamicin with high concentration and quinolones.Conclusions The pathogen cultured in hospitalized patients of department of urology is manily E.coli which has high resistance to some drugs.Thus,it is important to take antibiotics appropriately based on monitoring urine culture,analyzing and summarizing drug resistance of bacteria frequently.