宜昌地区泌尿道感染病原菌构成及抗菌药物敏感性分析

目的 为指导临床医师合理使用抗菌药物提供理论依据。方法 回顾性分析宜昌市中心人民医院2012年至2018年尿培养阳性的门诊及住院患者，按时间分为A组(2012—2014年)与B组(2015—2018年)，对比分析两组主要病原菌分布情况，以及各病原菌抗菌药物敏感趋势。结果 ①共培养出6596株病原菌，其中A组1857株，B组4739株。A组与B组排名前5位细菌均为大肠埃希菌、粪肠球菌、屎肠球菌、肺炎克雷伯菌和铜绿假单胞菌。②B组中大肠埃希菌对常见抗菌药物敏感性均高于A组，且具有统计学意义。③A组中粪肠球菌对环丙沙星的敏感率高于B组，分别为45.2%和30.6%，B组粪肠球菌对其他抗菌药物敏感率均高于A组，且其中四环素、氨苄西林、万古霉素具有统计学意义。④B组中屎肠球菌对四环素的敏感率略高于A组，分别为42.4%和42.8%，B组屎肠球菌对其他抗菌药物敏感率则更低。结论 泌尿道感染最常见病原菌为大肠埃希菌及肠球菌，占病原菌的70%~80%。常用抗菌药物的敏感率呈上升趋势，临床上规范合理使用抗菌药物对减少病原菌耐药、治疗泌尿道感染具有重要意义。

Composition and sensitivity analysis of pathogenic bacteria in urinary tract infections in Yichang area

Objective To provide theoretical basis for guiding clinicians to use antibiotics reasonably. Methods The outpatients and inpatients with positive urine culture from 2012 to 2018 in Yichang Central People’s hospital were analyzed retrospectively. The outpatients and inpatients were divided into group A (2012—2014) and group B (2015—2018) according to the time. The distribution of the main pathogens in the two groups and the antimicrobial susceptibility trend of each pathogen were compared and analyzed. Results (1)A total of 6,596 strains of pathogenic bacteria were cultured. including 1,857 strains in group A and 4,739 strains in group B. The top 5 bacteria in group A and B were Escherichia coli, Enterococcus faecalis, Enterococcus faecium, Klebsiella pneumoniae and Pseudomonas aeruginosa. (2)The sensitivity of Escherichia coli in group B to common antibiotics was higher than that in group A, and it was statistically significant. (3) The sensitivity of Enterococcus faecalis to ciprofloxacin in group A was higher than that in group B, which was 45.2% and 30.6% respectively. Meanwhile, the sensitivity of Enterococcus faecalis in group B to other antibiotics was higher than that in group A, and, tetracycline, ampicillin and vancomycin had statistical significance. (4) The sensitivity rate of Enterococcus faecium to tetracycline in group B was slightly higher than that in group A (42.4% and 42.8%, respectively). On the other hand, the sensitivity rate of Enterococcus faecium in group B to other antibiotics was lower. Conclusion The most common pathogens of urinary tract infection are Escherichia coli and Enterococcus, which accounting for 70%~80% of the total pathogens. The sensitivity rate of commonly used antibiotics is on the rise. It is of great significance to reduce the drug resistance of pathogenic bacteria and treat urinary tract infection.