泌尿系统结石合并感染患者尿液标本病原菌分布及耐药性分析

Distribution and drug resistance of pathogens isolated from urine specimens of urinary tract calculi patients complicated with infection

目的研究泌尿系统结石合并感染患者尿液标本中病原菌分布及耐药性。方法选取2015年8月-2017年7月医院泌尿系统结石患者398例,回顾性观察、目标性监测泌尿系统结石合并感染患者尿液标本中病原菌分布及耐药性。结果398例泌尿系统结石患者合并尿路感染98例,感染率为24.62%;98例感染患者尿液标本培养出病原菌90株,检出率91.84%,其中革兰阴性菌63株占70.00%、革兰阳性菌21株占23.33%、真菌6株占6.67%;大肠埃希菌对氨苄西林、哌拉西林和莫西沙星耐药率较高,均>80%;对哌拉西林钠/他唑巴坦与亚胺培南较低,耐药率<10%,对阿米卡星及美罗培南耐药率为0;粪肠球菌对庆大霉素、红霉素和利福平耐药株数较多,对氨苄西林/舒巴坦、万古霉素、替考拉宁与利奈唑胺耐药株数为0。结论泌尿系统结石合并感染患者病原菌分布正不断变化,耐药性升高,加强本地区患者尿液标本培养,定期观察病原菌分布特点、监测耐药性,有助于掌握本地区病原菌流行特点,根据培养结果和药敏试验选取合理、有效抗菌药物,利于降低或控制病原菌变异和耐药率。

OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from urine specimens of urinary tract calculi patients complicated with infection.METHODS A total of 398 patients with urinary tract calculi who were treated in hospitals from Aug 2015 to Jul 2017 were enrolled in the study.Retrospective study and targeted monitoring were performed for the distribution and drug resistance of the pathogens isolated from the urinary tract calculi patients complicated with infection.RESULTS Of the 398 urinary tract calculi patients,98 were complicated with urinary tract infection,with the infection rate 24.62%.Totally 90 strains of pathogens were isolated from the 98 patients with infection,with the isolation rate 91.84%,63（70.00%）of which were gram-negative bacteria,21（23.33%）were gram-positive bacteria,and 6（6.67%）were fungi.The drug resistance rates of Escherichia coli strains to ampicillin,piperacillin and moxifloxacin were more than 80%,the drug resistance rates to piperacillin sodium-tazobactam and imipenem were less than 10%,and the drug resistance rates to amikacin and meropenem were 0.There were many Enterococcus faecalis strains that were resistant to gentamicin,erythromycin and rifampicin,and no strain was resistant to ampicillin-sulbactam,vancomycin,teicoplanin or linezolid.CONCLUSIONS The distribution of the pathogen isolated from the urinary tract calculi patients complicated with infection changes constantly,and the drug resistance rates are increasing.It is necessary to strengthen the culture of urine specimens,regularly observe the distribution of pathogens and monitor the drug resistance so as to facilitate the understanding of prevalence of the pathogens,reasonably use antibiotics based on the results of culture and drug susceptibility testing and reduce or control the variation strains and drug resistance rates.