泌尿系感染的病原菌分布及耐药性分析

目的了解廊坊地区泌尿系感染的病原菌分布及耐药性,为临床正确诊断、合理应用抗菌药物提供科学依据。方法对尿液标本中分离出的846株病原菌,用K-B法进行体外药物敏感试验,并对特殊耐药株如耐甲氧西林葡萄球菌(MRS)、耐万古霉素肠球菌(VRE)、高耐庆大霉素肠球菌(HLAR)、ESBLs细菌进行检测。结果分离数在前5位的病原菌依次为大肠埃希菌(60.2%)、凝固酶阴性葡萄球菌(16.7%)、肺炎克雷伯菌(3.2%)、肠球菌属(5.1%)、变形菌属(2.1%);检出率为产ESBLs细菌(23.5%)、MRS(83.7%)、HLAR(59.1%),未发现VRE菌株;大肠埃希菌对头孢吡肟、哌拉西林/他唑巴坦、头孢他啶、阿米卡星敏感性较好(71.0%~99.0%);凝固酶阴性葡萄球菌对万古霉素、哌拉西林/他唑巴坦、呋喃妥因、氧氟沙星敏感性较好(70.0%~100.0%),未发现耐万古霉素葡萄球菌属。结论大肠埃希菌为本地区泌尿系感染的主要病原菌,其次为凝固酶阴性葡萄球菌,以往用于治疗泌尿系感染的常用药物如庆大霉素、环丙沙星等已产生较高的耐药性,因此,临床医师应结合药物敏感试验和特殊耐药菌株的报告,合理使用抗菌药物,减少、减缓耐药株的产生。

Pathogenic Bacteria Disrtibution and Drug Resistance of Urinary System Infection

OBJECTIVE To understand pathogen distribution and drug resistance of urinary system infection in Langfang,then help the clinic to use drug rationally.METHODS Totally 846 bacteria were isolated from the urine and given in vitro drug sensiticity test with Kirby-Bauer method to detect special resistant strains such as MRS,VRE,HLAR and the ESBLs-producing bacteria.RESULTS The first 5 were Escherichia coli(60.2%),cogulase negative Staphylococcus (CNS,16.7%),Klebsiella pneumoniae(3.2%),Enterococcus(2.6%),and Proteus(2.1%).ESBLs-producing bacteria were 23.5%,MRS were 83.7%,HLAR were 59.1%,VRE were not detected.E.coli was sensitive to cefepime,piperacillin/tazobactam,ceftazidime,amikacin(71.0-99.0%).CNS was sensitive to vancomycin,piperacillin/tazobactam,nitrofurantoin,and ofloxacin(70.0-100.0%).Vancomycin-resistant CNS was not detected.CONCLUSIONS E.coli is the most encountered pathogen causing urinary system infection in Langfang,Then are CNS.Antibiotics we were used such as gentamicin,ciprofloxacin,et,al already produced higher resistance,so clinic should consider the drug sensitivity agent and special resistant strain and choice antibiotics rationally,to make the resistant streains decreasing in number.