泌尿系感染病原菌分布及耐药性分析

目的 探讨泌尿系感染病原菌的种类及耐药性,为临床规范治疗泌尿系感染提供科学依据. 方法 尿培养病原菌的分离鉴定与药敏试验使用法国生物梅里埃公司VITEK 2 compact全自动微生物分析系统及配套细菌鉴定卡和药敏卡进行. 结果 尿培养病原菌以革兰阴性杆菌为主,共分离出455株,占77.78％,其中大肠埃希菌居第1位,分离出372株,占41.88％,其次为肺炎克雷伯菌85株,占14.53％,大肠埃希菌对所检测的18种抗菌药物产生了不同的耐药性,耐药率最低的抗菌药物是亚胺培南、厄它培南、丁胺卡那、头孢替坦、氨苄西林/舒巴坦、环丙沙星和哌拉西林/他唑巴坦,耐药率分别是4.90％、6.12％、6.53％、6.94％、7.10％、7.84％、8.57％. 结论 大肠埃希菌是引起泌尿系感染的主要病原菌,尿培养病原菌的耐药性在不同菌种之间有很大的差异,临床医师应根据尿培养分离菌种和药敏试验结果合理用药,以减少细菌耐药性的产生.

Distribution and Drug Resistance of Pathogenic Bacteria in Urinary Tract Infection

Objective To analyze the distribution and drug resistance of the common pathogenic bacteria in urinary tract infection so as to provide scientific reference for clinical reasonable use of antibacterial agents.Methods The identification of bacteria and antibacterial sensitivity tests of the isolates were performed by VITEK 2 compact measurement system.Results Gram-negative bacilli were the major pathogenic bacteria in urinary tract infection,accounted for 77.78％ （455 strains）,of which Escherichia coli and Klebsiella pneumoniae accounted for 41.88％ （372 strains） and 14.53％ （85 strains）,respectively.Drug resistances of Escherichia coli to 18 antibacterial agents showed different.The resistance rates of Escherichia coli to imipenera,ertapenem,amikacin,cefotetan,ampicillin-sulbactam,ciprofloxacin,and piperacillin/tazobactam were the lowest,which were 4.90 ％,6.12 ％,6.53 ％,6.94 ％,7.10 ％,7.84 ％,and 8.57 ％,respectively.Conclusions Escherichia coli is the main pathogenic bacterium causing urinary tract infection.The pathogenic bacteria of urinary tract infection show significantly different drug resistance.Clinicians should reasonably use antibacterial agents based on the results of clinical laboratory tests so as to reduce the drug resistance of bacteria.