男、女性尿标本中分离菌的耐药性分析

目的通过男、女性尿标本分离的常见革兰阳性球菌和革兰阴性杆菌对各种抗生素的耐药率调查,研究耐药性分析对于指导临床合理用药的意义。方法药物敏感性分析采用纸片扩散法(K-B法),用WHONET5软件分析结果;耐药率的显著性比较用x~2检验。结果男、女性患者尿标本中分离的前5种革兰阳性球菌和革兰阴性杆菌共计4 352株。占全部尿标本分离菌株数的71.5％;大肠埃希菌是泌尿道感染的最主要分离菌,其次为凝固酶阴性葡萄球菌、粪肠球菌、肺炎克雷伯菌、表皮葡萄球菌等;女性患者尿标本的分离菌株数高于男性患者的分离株数。多数男性患者尿标本分离的菌株的耐药率高于从女性患者尿标本分离的菌株。男性患者尿标本分离的粪肠球菌对青霉素、氨苄西林和环丙沙星的耐药率分别为39.8％、41.3％和59.3％,明显高于女性患者尿标本分离菌株的21.2％、25.8％和40.8％(P<0.01);男性患者尿标本分离的大肠埃希菌对头孢唑林、头孢他啶、头孢噻肟、阿莫西林/克拉维酸、阿米卡星和氨曲南的耐药率分别为49.3％、9.5％、32.5％、30.4％、11.5％和17.9％,明显高于女性患者尿标本分离菌株的耐药率32.1％、4.9％、17.7％、20.9％、6.9％和10.8％(P<0.01～0.05);肺炎克雷伯菌对头孢唑林、头孢他啶、头孢噻肟、阿莫西林/克拉维酸、环丙沙星、左氧氟沙星、阿米卡星、庆大霉素和氨曲南;奇异变形杆菌对头孢他啶,男、女性患者尿标本分离菌株的耐药率有显著性差别(P<0.01～0.05)。结论男、女性患者尿标本中的分离菌对某些抗生素的耐药率之间存在明显不同,耐药性分析对于指导临床合理用药具有实际意义。

Study on Antimicrobial Resistance of Pathogens from Urine Specimens Between Male and Female Patients

Objective To investigate the antimicrobial resistance of gram-positive and gram-negative pathogens from u- rine specimens between male and female patients.and study on the significance for guiding rational use of antimi- crobial agents in clinic.Methods Disc diffusion test(K-B method)was used to study the antimicrobial resist- ance,and WHONET 5 was used for statistics analysis; and significant differences were identified by X~2 test among the rates of resistance to antibiotics.Results 4352 isolates of the most common 5 gram-positive and gram- negative isolates were collected from urine specimens,and were 71.5％ in total strains from urine.Escherichia Coli was the most common strains in the urinary tract infections,consequently,Enterococcus faecalis,Staphylo- coccus epdermidis and Klebsiella pneumonia were the second,third, and forth strains with urinary tract infections, respectively. The number of isolates from female patients were more than that of male patients.Most of isolates from male patients were higher than that from female patients in resistant rates.Resistant rates in Enterococcus faecalis to penicillin(39.8％),ampicillin(41.3％)and ciprofloxacin(59.3％)in male patients were higher than those from female patients, Escherichia colito cefazolin(49.3％),ceftazidime(9.5％), cefotaxime(32.5％), amoxicillin/clavulanic acid (30.4％), amikacinand(11.5％)and aztreonam(17.9％)in isolates from male pa- tients were higher than those rates of 32.1％、4.9％、17.7％、20.9％、6.9％ and 10.8％, respectively, from fe- male patients, Klebsiella pneumonia to cefazolin, ceftazidime. cefotaxime, amoxicillin/clavulanic acid, ciprofloxa- cin, levofloxacin, amikacin, gentamicin and aztreonam and, Proteus mirabilis to ceftazidime;Those differences were significant(p<0.01～0.05)by X~2 test.Conclusions Resistant rates were differences significantly between the isolates from male and female patients to some anhbiotics it is important to guide the rational use of antimicro bial agents in clinic by resistant analysis.