复杂性尿路感染的病原菌分布及革兰阴性杆菌的耐药性分析

Distribution of pathogens in complicated urinary tract infection and drug resistance of Gram - negative bacteria

目的探讨十堰地区复杂尿路感染病原菌分布及主要致病菌革兰阴性杆菌的耐药情况分析。方法选择2014年1月至2017年1月在湖北医药学院附属人民医院195例复杂性尿路感染患者，留取中段尿液，完善尿培养及药物敏感试验，运用WHONET3．7细菌耐药性监测网进行分析结果。结果195例标本中共分离出致病菌146株，其中革兰阴性杆菌株98株（67．12％），革兰性阳性球菌为42株（28．77％）、厌氧菌为6株（4．11％）。革兰阴性杆菌主要是大肠埃希菌（29．45％）、铜绿假单胞菌（13．70％）有上升趋势，奇异变形杆（9．59％）位于第三位。这三种革兰阴性菌对哌拉西林、头孢哌酮舒巴坦、左氧氟沙星等药物的耐药性均超过40％，对于亚胺培南、阿米卡星耐药性均低于10％，由此统计数据可以看出复杂尿路感染耐药情况严重。结论复杂尿路感染的病原菌仍然以革兰氏阴性杆菌大肠埃希菌为主，且耐药性严重，需密切结合药敏结果合理联合抗感染治疗，以减少耐药菌株的出现。

Objective To investigate the distribution of pathogens in complex urinary tract in- fection and the drug resistance of Gram - negative in the main pathogens in Shiyan area. Methods From January 2014 to January 2017, 195 patients with complicated urinary tract infection were enrolled in the hospital, and urine was collected in the middle stage. Urine culture and drug sensitivity test were carried out. The results were analyzed by WHONET 3.7 monitoring network of drug resistance. Results Of the 195 samples, 146 strains were isolated, 98 strains were Gram - negative strains （ 67. 12% } , 42 strains were Gram- positive cocci （28.77%） and 6 strains（4.11% ） were anaerobic bac- teria. Gram - negative bacilli were mainly Escherichia eoli （29.45%） , Pseudomonas aeruginosa （ 13. 70%） had an upward trend, and the singular deformed rod （9.59%） was the third. These three Gram- negative bacteria resistance to piperacillin, cefoperazone sulbactam, levofloxacin and other drugs were more than 40% ,resistance to imipenem, amikaein was less than 10% and drug resistance of complex urinary tract infection was serious. Conclusions The pathogens of complex urinary tract infection are mainly Gram - negative bacilli Escherichia eoli, and the drug resistance is serious, it need to be closely combined with the results of drug susceptibility combined with anti - infective treatment to reduce the emergence of drug - resistant strains.