泌尿系感染的病原菌分布及耐药性分析

目的了解泌尿系感染患者的病原菌分布及耐药性,指导临床合理用药. 方法从尿标本中分离出670株(男性217株,女性453株)病原菌进行耐药性分析,特殊耐药株如MRS株、VRE株、HLAR株、产ESBLs细菌的检测及体外药敏试验均采用K-B法. 结果分离前5位的细菌依次为大肠埃希菌(占54%)、凝固酶阴性葡萄球菌(6%)、肺炎克雷伯菌(5%)、铜绿假单胞菌(4%)、弗氏柠檬酸杆菌(4%);产ESBLs细菌的检出率为11.6%,MRSCON株为74.3%,VRE株为28.9%,HLAR株为70.3%;大肠埃希菌对阿米卡星、呋喃妥因和β-内酰胺类抗生素(青霉素类除外)敏感性较好(72%～97%),对喹诺酮类抗生素较差(16%～18%). 结论大肠埃希菌为泌尿系感染的主要病原菌,占>50%;女性患者明显高于男性;过去常用于治疗泌尿系感染的喹诺酮类抗生素,耐药性较高;临床应结合药敏试验和特殊耐药株的报告结果,合理选择抗生素.

Pathogens in Urinary System:Their Destribution and Resistance Analysis

OBJECTIVE To investigate the distribution and drug resistance of the pathogens in the patients who suffered from the urinary infection, then help the clinic to use drug rationally. METHODS A total of 670 bacteria were isolated from the urine and given resistance analysis (men 217 strains, women 453 strains). The test and extra corporeal antimicrobial agents susceptibility took K-B method which was used for special resistant strains such as MRS, VRE, HLAR and the ESBLs-produced bacteria. RESULTS The first 5 were Escherichia coli (54%), coagulase negative staphylococcus (6%), Klebsiella pneumoniae (5%), Pseudomonas aeruginosa (4%), and Citrobacter freundii (4%). The rate of test was different, ESBLs-produced bacteria were 11.6%, MRSCON 74.3%, VRE 28.9%, HLAR 70.3%. E. coli was sensitive to amikacin, nitrofurantoin and beta-lactam antibiotics (except penicillin) (72-97%), but less sensitive to quinolones antibiotics (16-18%). CONCLUSIONS More than half of the urinary pathogens is E. coli; women are more significant than men. Quinolones antibiotics which we used before have high resistance, so the clinic should consider the antimicrobial agent susceptibility and special resistant strain test report and choice drug rationally.