门诊与住院患者尿路感染的病原菌分布及耐药性比较

目的通过比较门诊和住院患者尿路感染的病原菌分布与耐药性，为临床合理应用抗生素提供依据。方法根据感染来源，将尿路感染患者分为门诊组和住院组，回顾分析两组尿路感染的菌群分布、药敏情况和易感因素。采用WHONET5．4软件和SPSS17．0统计学软件进行数据分析。结果门诊组共检出9种病原菌，住院组则检出49种病原菌。门诊组与住院组感染的病原菌均以革兰阴性杆菌为主，其中又以大肠埃希菌为主，分别占75．27％、30．06％．组间比较差异有统计学意义。大肠埃希菌的药敏结果显示：除头孢曲松、头孢克肟分别在组间比较差异有统计学意义外，其余抗生素组间比较差异均无统计学意义。门诊组与住院组产ESBLs的大肠埃希菌的检出率分别占55．71％、64．29％。结论尿路感染最常见是大肠埃希菌，病原菌存在较高的耐药性。重视病原菌的监测和耐药性分析，对指导临床合理使用抗生素，控制尿路感染具有重要意义。

Comparison of Antimicrobial Resistance in Pathogens Causing Urinary Tract Infections between Outpatient and Inpatient

Objective To compare the pathogens causing urinary tract infections and their drug resistance between the outpatient and inpatient, and provide evidence for clinical rational use of antibiotics. Methods The patients with urinary tract infection were divided into the outpatient group and inpatient group according to the source of infection. The distribution of the bacterial flo- ra, drug susceptibility and predisposing factors were analyzed retrospectively. The results were evaluated using WHONET and SPSS. Results Total 9 kinds of pathogens were isolated from the outpatient group, and 49 kinds of pathogens from the inpatient group. The gram-negative bacteria（75.27% ）, especially Escherichia coli strains（30.06% ） were common in both groups, and the difference was significant between the two groups. Drug susceptibility testing showed that the sensitivity of Eseherichia coli had significant difference only to ceftriaxone and cefixime between the two groups. The positive rate of E. coli that can produce extend- ed-spectrum J3-Lactamases（ESBLs） was 55.71% in the outpatient group and 64.29% in the inpatient group. Conclusion E. coli is the most common pathogens in urinary tract infection and has an increased tolerance against specific types of antibiotics. We should pay more attentions to the monitoring of pathogens and resistance analysis. It is of great significance for the clinician application of antibiotics and controlling the urinary tract infection.