我院2012年住院病人尿液标本病原菌分布及药敏分析

目的了解我院住院病人尿培养病原菌分布及耐药情况，为临床合理选用抗生素提供依据。方法收集2012年我院住院病人尿培养及药敏结果，对其病原菌分布及耐药情况进行分析。结果该年度共分离病原菌583株，阳性率为47．79％，其中革兰阴性菌占61.06％，革兰阳性菌占26．59％，真菌占12．35％；前几位病原菌为大肠埃希菌（34．13％），屎肠球菌（11．66％），肺炎克雷伯菌（9．78％），铜绿假单胞菌（6．17％）；科室分布集中于老年病房（22．98％），泌尿外科（18．52％），内分泌科（11．32％），肾内科（10．63％），综合ICU（9．61％）。大肠埃希菌及肺炎克雷伯菌中产超广谱β-内酰胺酶（ESBLs）者检出率分别为56．78％和56．14％，耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出率为47．06％。结论我院住院病人泌尿系感染率较高，大肠埃希菌仍为主要致病菌。大肠埃希菌和肺炎克雷伯菌对几种β-内酰胺酶复合制剂及阿米卡星的耐药率较低，可作为经验用药；万古霉素、利奈唑胺、替考拉宁、替加环素是治疗肠球菌感染的有效药物。

PATHOGEN DISTRIBUTION AND DRUG SENSITIVE ANALYSIS OF URINE SPECIMENS IN HOSPITALIZED PATIENTS IN 2012

Objective To investigate the distribution of pathogens in urine culture and its drug resistance of hospitalized patients and provide reference for rational clinical use of antibiotics. Methods Results of urine culture and drug sensitive test of patients hospitalized in our hospital in 2012 were collected and analyzed with regard to distribution of pathogenic bacteria and drug resistance. Results A total of 583 （47.79%） strains were isolated. Of which, gram-negative and positive bacteria and fungi accounted for 61.06%, 26.59%and 12.35%, respectively, the first several pathogenic bacteria were Escherichia coli （34.13%）, En teroeoccus faecinm （11.66%）, Klebsiella pneumonia （9.78%） and Pseudomonas aeruginosa （6.17 %）. The distribution focused on departments of geriatrics （22.98%）, urology （18.52%）, endocrinology （11.32%）, nephrology （10.63%） and intensive care unit （9.6%）. Extended spectrum 13-Lactamases （ESBL） producing bacteria were found in 56.78% of Escherichia eoli and 56.14% of Klebsiella pneumonia, and Methicillin-resistant coagulase-negative staphylococci （MRCNS） were detected in 47.06%. Conclusion The infection rate of urinary system is higher in in-patients of our hospital, Escherichia coli being the main pathogenic bacteria. Escherichia coli and Klebsiella pneumonia are relatively sensitive to β-lactamase compound and Amikaein, which can be used for empirical therapy. Vancomycin, linezolid, teicoplanin, and tigecycline are effective for urinary infection caused by gram-positive