皖南地区尿培养病原菌种类分布与耐药性分析

Distribution and Antimicrobial Resistance of Pathogens Isolated from Urine Culture in Southern Anhui

目的:统计分析皖南医学院弋矶山医院收集的尿培养阳性标本的病原菌分布及耐药性,为临床合理使用抗菌药物提供依据。方法:收集2013年1月至2016年12月在我院住院患者的中段尿进行尿培养,培养生长的细菌经过分纯在VITEK2 Compact全自动微生物鉴定仪进行菌种鉴定和药敏分析,统计和分析4年来尿培养的病原菌的种类分布与耐药性。结果:6 480份中段尿细菌培养标本共检出1 762株病原菌,革兰阴性菌963株(54.65%),以大肠埃希菌最为常见;革兰阳性菌643株(36.49%),以粪肠球菌为主;真菌156株(占8.85%),以白色假丝酵母菌及光滑假丝酵母菌多见。病原菌对各种抗菌药物耐药的差异性较大,表现为多药耐药;产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌、肺炎克雷伯菌的检出率分别为57.55%(324/563)和24.49%(24/98),而耐甲氧西林金黄色葡萄球菌的检出率为28.57%(6/21)。结论:及时对地方性的尿培养病原菌的分布及耐药性进行统计和分析,对控制地方性耐药菌株传播、指导临床合理选用抗菌药物具有重要的临床意义。

Objective： To analyze the distribution and antimicrobial resistance of pathogens in the urine, so as to provide evidence for rational use of antibiotics. Methods：The midstream urine cuhure of inpatients from Jan 2013 to Dec 2016 was collected. The bacterial species and drug sensitivity were identified by VITEK2 Compact automatic microbial identification system. The distribution and drug resistance of pathogenic bacteria were analyzed statistically. Results： Totally 1 762 strains of pathogenic bacteria were detected in 6 480 bacterial cuhures of urine samples. Gram-negative bacteria accounted for 963 strains （54.65%） , mainly Escherichia coll. Gram-positive bacteria accounted for 643 strains （36.49%）, mainly Enterococcus faecalis . And 156 strains of fungi （8.85%） were detected, mainly Candida albicans bacteria and Candida glabrata. Antimicrobial resistance of pathogens showed muhi-drug resistance. The detection rates of Escherichia coli and Klebsiella pneumoniae producing ESBLs were 57.55% （324/ 563） and 24.29% （24/98） respectively, and the detection rate of meticllin-resistant S. aureus was 28.57% （6/21）. Conclusion： Timely analysis of the distribution and antimicrobial resistance of pathogens in the local urine culture is of great clinical significance %r controlling the spread of drug-resistant strains and guiding the clinical rational use of antimicrobial drugs.