2015～2018年攀钢集团总医院尿液培养病原菌分布及耐药性分析

The distribution and drug resistance of pathogens in urine culture inPanzhihua Pangang Group General Hospital from 2015 to 2018

目的分析攀钢集团总医院尿液培养病原菌分布及耐药情况,为后期抗生素使用提供临床依据。方法对我院2696例送检尿液标本进行病原菌培养以分析病原菌分布及耐药性。结果送检尿液培养病原菌共2253株,其中革兰氏阴性菌占78. 92%,以大肠埃希菌最常见(占63. 07%);革兰氏阳性菌占16. 56%,主要是粪肠球菌和屎肠球菌;真菌占4. 52%。送检尿液病原菌主要分布在内科(41. 32%)和泌尿科(40. 17%)。大肠埃希菌和奇异变形杆菌对氨苄西林、复方新诺明和头孢唑啉,肺炎克雷伯菌对复方新诺明和头孢唑啉,铜绿假单胞菌对呋喃妥因和头孢替坦耐药率较高。屎肠球菌和粪肠球菌对大部分抗菌药耐药。大肠埃希菌和肺炎克雷伯菌中ESBLs检出率为43. 21%和26. 22%。结论对尿液培养病原菌分布及耐药性了解有利于临床医生合理使用抗生素,避免新型耐药菌出现。

Objective To analyze the distribution and drug resistance of pathogens in urine culture in Panzhihua Pangang Group General Hospital in order to provide clinical evidence for following use of antibiotics.Methods We collected 2696 urine samples from the hospital for pathogen culture to analyze the distribution and drug resistance of pathogens.Results A total of 2253 strains of urine-cultured bacteria were collected.Of these stains,the gram-negative bacteria accounted for 78. 92% and Escherichia coli was more common,accounting for 63. 07%.The gram-positive bacteria accounted for 16. 56%,mainly including Enterococcus faecalis and Enterococcus faecium. Fungi only accounted for 4. 52%. The urine pathogens were mainly distributed in internal medicine department (41. 32%) and urology department (40. 17%). The resistance rates of Escherichia coli and Proteus mirabilis to ampicillin,trimethoprim-sulfamethoxazole and cephazoline,resistance rates of Klebsiella pneumoniae to trimethoprim-sulfamethoxazole and cephazoline,and resistance rates of Pseudomonas aeruginosa to nitrofurantoin and cefotetan were all high. Enterococcus faecium and Enterococcus faecalis were resistant to most antimicrobial agents.The detection rates of ESBLs from Escherichia coli and Klebsiella pneumoniae were43. 21% and 26. 22%,respectively.Conclusion The understanding of the distribution and drug resistance of pathogens in urine culture is beneficial to the rational use of antibiotics by clinicians and avoids the emergence of new drug-resistant bacteria.