泌尿系感染菌谱及耐药性分析

目的：探讨泌尿系感染患者细菌分布及耐药性,指导临床医生合理用药。方法：通过Kirby-Bauer法及ESBLs的检测对自泌尿系感染患者分离获得的380株病原菌的分布及耐药性进行分析。结果：380株细菌,革兰阴性菌272株（71．6％）,革兰阳性菌占108株（28．4％）。居前5位的病院菌依次为：大肠埃希氏菌190株（50．0％）、金黄色葡萄球菌42株（11．1％）、表皮葡萄球菌34株（8．9％）、粪肠球菌22株（5．8％）、阴沟肠杆菌20株（5．3％）。革兰阴性菌与革兰阳性菌对多种抗生素均有较高的耐药率,但前者对亚胺培南较敏感（94．4％）,后者对万古霉素、替考拉宁敏感（100．0％）。产ESBLs大肠埃希氏菌株达38．8％,其对多种抗生素的耐药性明显高于非产酶株。结论：引起泌尿系感染的细菌谱尽管很广泛,但仍以革兰阴性菌为主,大肠埃希氏菌最常见达50％,其产ESBLs菌株的耐药性明显高于非产酶株,提示泌尿系病原菌的ESBLs监测对指导,临床医生合理使用抗生素具有非常重要的意义。

Analysis on Urinary System Infection Pathogens and Drug Resistance

Objective： To explore the present status and drug resistance of pathogens in urinary system infection. Methods： 380 pathogen strains in urinary system infection from inpatients and outpatients from 2004 to 2007 were identified. The drug resistance test was preformed by Kirby-Bauer method. The ESBLs-preducing Escherichia coli was detected. Results： Escherichia coli rated the top one （50. 0%）, the next was Staphylococcus aureu, Staphylococcus epidermidis, Enterococcus faeealis, Enterobacter cloacae, Klebsiella pneumoniae. The result of drug resistance suggested that gram-negative and grampositive bacteria be resistant to several antibiotics, but the former was still sensitive to imipenem （94. 4%）, the latter was still sensitive to Teicoplanin and Vaneomycin （100.0% ）. Drug resistance of ESBLs--producing E. coil was more serious than that of non- ESBLs--producing strains to 11 antibitics. Conclusion： E. coli is the main pathogen in urinary infection. Rational use of antibiotics should be carried out according to urine culture results.