泌尿系感染病原菌的变迁及耐药性分析

目的了解近年来泌尿系感染病原菌的变迁及耐药现状. 方法应用回顾性调查分析方法,对我院1997至2000年间泌尿系感染检测的1 026株病原菌的分布及耐药性进行统计分析. 结果在泌尿系感染的病原菌中,G+球菌上升,G-杆菌下降,真菌上升,其中粪肠球菌上升和变形菌属下降差异有显著性(P<0.05),药敏实验结果对以往常用的抗菌药物青霉素类、复方新诺明、红霉素、诺氟沙星及一代头孢显示较高的耐药性,2000年耐药率>81.6%,对三代头孢、环丙沙星、庆大霉素呈中度耐药,耐药率在42.9%～78.3%,对阿米卡星及头孢哌酮/舒巴坦呈轻度耐药,耐药率<36.7%. 结论随着抗生素的更新换代、人口老龄化及医院感染等因素的变化,泌尿系感染病原菌的分布及耐药性均发生了变迁.

Variation and Drug Resistance of Pathogens in Urinary System Infection

OBJECTIVE To know the present situation on variation and drug resistance of pathogens in urinary system infection. METHODS A total of 1 026 strains pathogens in urinary system infection from 1997 to 2000 were analyzed retrospectively. RESULTS Among pathogens of urinary system infection, the amount of G + cocci went up and of G - bacilli went down and of fungi also increased. Specially, the changes of Enterococcus faecalis and Proteus were significant (P<0.05). Escherichia coli was the main pathogen in urinary system infection and showed drug resistance to penicillins, trimethoprim/sulfamethoxazole, erythromycin, norfloxacin and the first generation cephalosporins (drug resistant rate 81.6%) in 2000. The resistance to the third generation cephalosporins, ciprofloxacin and gentamicin were mediate (drug resistant rates: 42.9 78.3%) and the resistance to amikacin and cefoperazone/sulbactam were low (drug resistant rates are less than 36.7%). CONCLUSIONS Drug resistance and distribution of pathogens in urinary system infection are vaying with the renew of the antibiotics, aging of the population and occurring of the hospital infection.