泌尿系统感染细菌病原学临床监测分析

目的了解近4年泌尿系统感染(UTI)细菌构成比与耐药性变化。方法采用多平板不同条件接种UTI患者尿标本进行细菌培养,采用BioMerieux VITEK2型全自动微生物仪与ID卡进行菌种鉴定,采用双纸片表型确证扩散法进行产超广谱β-内酰胺酶大肠埃希菌检测,采用Kirby-Bauer琼脂扩散法进行抗菌药物敏感试验,采用WHONET5.3软件进行数据统计分析。结果检出细菌768株,分布为G+菌/G-菌=26.4%/73.6%,大肠埃希菌占比49.2%。其他优势菌Sa、Se、ET、Kp、Ec及Pa占比分别为7.6%、6.8%、5.2%、6.5%、5.7%及4.9%,耐药率增高/持平/降低的品种分别为9/4/3、7/7/2、8/4/4、11/4/3、12/5/1及12/4/2个。134个药敏试验组合中82个(61.2%)为耐药率增高。结论 UTI细菌构成比例与耐药性在不断变化中,主要菌种对常用抗菌药的耐药率超6成在增高。提高标本送检率,加强临床监测,对减缓细菌抗药性蔓延与恶化有积极意义。

Clinical monitoring analysis on bacteria etiology in urinary tract infections

OBJECTIVE To understand bacteria constituent ratio and drug resistance change of urinary tract infection in nearly four years.METHODS Used many different conditions of vaccination in UTI patients’ urine sample to culture bacteria.Adopted BioMerieux VITEK 2 full-automatic microbial apparatus and ID card to identify bacteria species,adopted double pieces phenotype confirmed diffusion method to detect super broad-spectrum beta-lactamase of escherichia coli,adopted k-b AGAR diffusion test method to carry out antimicrobial susceptibility test,used WHONET5.3 software to analyze statistical data.RESULTS In detected 768 strains of bacteria,G+ bacteria/G-bacteria = 26.4%/73.6%,Escherichia coli proportion was 49.2%.Sa,Se,ET,Kp,Ec,Pa proportion were respectively 7.6%,6.8%,5.2%,6.5%,5.7%,4.9%.Drug resistance rate:heightened/flat/lower varieties were respectively 9/4/3,7/7/2,8/4/4,11/4/3,12/5/1,12/4/2.82(61.2%)drug-resistance were heightened in 134 combinations of drug sensitive test.CONCLUSION The proportion and drug resistance of UTI bacteria are in the constant change.The drug resistance of main strains to common antibiotics increases over 60%.Enhancing detection rate of samples and strengthening clinical monitoring have the positive value in slowing the spread of drug resistance.