泌尿道感染病原菌的变迁及抗生素敏感性研究

目的监测四年来泌尿道感染病原菌的菌群分布和耐药性变迁，指导临床合理应用抗生素。方法回顾性分析2000-2003年门诊及住院泌尿道感染患者病原菌的菌群分布和耐药性变迁。结果大肠埃希菌是引发泌尿道感染的主要病原菌，占50％左右，其次是凝固酶阴性葡萄球菌、肠球菌、念珠菌。四年相比，凝固酶阴性葡萄球菌、肠球菌和念珠菌检出率明显增多。大肠埃希菌对头孢菌素一代、二代耐药性较强，达到了50％左右，对头孢菌素三代、四代的敏感性较高。耐苯唑西林的凝固酶阴性葡萄球菌分离率由2000年的63．6％增加到2003年的78．8％；万古霉素的耐药率为0％。肠球菌对喹诺酮类抗生素的耐药率都达到50％以上，对万古霉素的耐药率稳中有升，从2000年的2．3％增加到2003年的6．1％。结论近年来泌尿道感染病原菌的菌群分布和耐药性发生变化，临床医师必须密切关注本院流行病学变化、病原菌分布及耐药性变迁，合理应用抗生素，减少耐药菌播散。

DISTRIBUTION AND DRUG RESISTANCE OF PATHOGENS IN URINARY TRACT INFECTION

ObjectiveTo study the pathogens and drug-resistance spectrum of bacteria from patients with urinary tract infection(UTI) in recent four years, and to direct physicians to use antibiotics correrpondingly.MethodsPathogens and their drug-resistance spectrum from patients with urinary tract infection were analyzed retrospectively. ResultsEscherichia coli (E. coli)was still the most common pathogen in UTI. Its isolation rate was about (50 %), next to it were coagulase-negative-staphlococcus(CNS), Enterococcus, and candida. In recent four years, the proportion of CNS, Enterococcus and candida had been increasing significantly. Drug-resistance of E. coli to first and second cephalosporin was about 50%,while that to third and fourth cephalosporin was more sensitive. Methicillin resistance CNS was isolated from (63.6 %) in 2000 to (78.8 %) in 2003. Its sensitive rate to vancomycin was 100%. Drug-resistance of Enterococcus to quinolones had reached above 50%, while drug-resistance to vancomycin was from (2.3 %) in 2000 to (6.1 %) in 2003. ConclusionClinician should conside these changes in clinical practice to get good effect and educe the spread of multidrug resistance bacteria in recent years.