湖北省中医院尿路感染病原菌分布与耐药性

Pathogens distribution and drug resistance of urinary tract infection in Hubei Provincial Hospital of Traditional Chinese Medicine

目的了解湖北省中医院尿路感染的病原菌分布及耐药情况,为预防和控制尿路感染提供依据。方法对湖北省中医院2016年1月至2017年12月门诊及住院尿路感染患者送检的567例尿液标本进行一般细菌分离、培养及药敏试验。结果 567例尿路感染患者共检出病原菌574株,其中革兰阴性菌413株,占72.0%,以大肠埃希菌为主,革兰阳性菌130株,占22.6%,以粪肠球菌为主;真菌31株,占5.4%。居前三位的病原菌分别为大肠埃希菌、粪肠球菌和肺炎克雷伯菌,2016年和2017年其构成比分别为50.9%、9.4%、7.0%和50.2%、10.8%、7.7%,差异均无统计学意义(P>0.05);大肠埃希菌对氨苄西林耐药率最高,为82.4%,对头孢噻肟、环丙沙星、左旋氧氟沙星、氨苄西林/舒巴坦和头孢曲松耐药率较高,为50%左右;粪肠球菌对奎奴普丁/达福普汀耐药率为100%,对克林霉素和四环素耐药率高达90%左右;肺炎克雷伯菌对氨苄西林耐药率最高,达100%,对其他种类抗菌药物均不同程度耐药。结论湖北省中医院泌尿道感染病原菌以大肠埃希菌、粪肠球菌和肺炎克雷伯菌为主,应依据药敏试验结果合理使用抗菌药物。

Objective To investigate the pathogens distribution and drug resistance of urinary tract infection (UTI) in Hubei Provincial Hospital of Traditional Chinese Medicine, and provide reference for the prevention and control of urinary tract infection. Methods From January 2016 to December 2017, the general bacterial were isolated and cultured of 567 urine samples from outpatients and inpatients of urinary tract infection in Hubei Provincial Hospital of Traditional Chinese Medicine. Then the bacterial identification and drug sensitivity test were performed. Results A total of 574 pathogens were detected in 567 urine samples of urinary tract infection. Among them, 413 strains (72.0%) were Gram-negative bacteria, mainly Escherichia coli, 130 strains (22.6%) were Gram-positive bacteria, mainly Enterococcus faecalis, and 31 strains were fungi (5.4%). The top three pathogens were Escherichia coli, Enterococcus faecalis, and Klebsiella pneumoniae, with the composition ratios of 50.9%, 9.4%, 7.0% in 2016 and 50.2%, 10.8%, 7.7% in 2017, respectively (P>0.05). The resistance rate of Escherichia coli to ampicillin was the highest (82.4%), followed by cefotaxime, ciprofloxacin, levofloxacin, ampicillin/sulbactam, and ceftriaxone (about 50%). Enterococcus faecalis was the most resistant to quinupridin/daputin (100%), and it was highly resistant to clindamycin and tetracycline (about 90%). Klebsiella pneumoniae was the most resistant to ampicillin (100%) and had different resistance to other kinds of antibiotics. Conclusion Escherichia coli, Enterococcus faecalis, and Klebsiella pneumoniae were the main pathogens of urinary tract infection in Hubei Provincial Hospital of Traditional Chinese Medicine. Antibiotics should be used reasonably according to the results of drug sensitivity test.