尿路感染菌群分布及耐药性分析

目的了解近年来成人尿路感染致病菌分布及耐药性情况,为临床合理使用抗生素提供理论依据。方法选择1999年1月至2005年10月我科住院治疗的尿培养阳性的尿路感染患者,分析其细菌培养结果及对抗生素的耐药性。结果160例尿培养阳性患者中,157例为细菌,3例为真菌。革兰阴性杆菌占77.8%,其中大肠埃希杆菌占51.3%;革兰阳性菌占20.6%。革兰阴性杆菌对阿莫西林耐药性高达85.9%,对第二代头孢菌素耐药性达24.0%,对第三代头孢菌素中的头孢他啶耐药率12.5%;对亚胺培南耐药率为0;对喹诺酮类抗生素耐药率57.6%;对氨基糖甙类抗生素中的庆大霉素、妥布霉素的耐药性达36.0%~51.0%;对磺胺类抗生素的耐药率为68.9%。结论目前尿路感染仍以大肠埃希杆菌为主,耐药菌株不断增加,临床医师在选择抗生素时,要参考当地细菌药敏试验结果合理用药。

The spectrum and antimicrobial resistance of pathogens causing urinary tract infection

Objective To investigate the spectrum and antimicrobial resistance of pathogens causing urinary tract infection in adult.Method To analyze the spectrum and antimicrobial resistance of pathogens collected from urine cultures in hospitalized patients for urinary infections from January 1999 to October 2005.Results 160 positive cultures were isolated,Of them,157 were bacilli,3 were fungi.Gram-negative bacilli accounted for(77.8%,)with 51.3% of Escherrich's bacilli coli,gram-postive bacilli accounted for 20.6%.Resistance rates of Gram negative bacilli to amoxicillin,second generation cephlosporins,ceftazidime,imipenem,quinolones,aminoglycosides such as gentamicin,tobramycin and sulfanilamide were 85.9%,24.0%,12.5%,0.0%,57.6%,36.0% ～51.0% and(68.9)%.Conclusions E coli is still the major pathogen accountcd for urinany tract infection.Resistancc rates among common pathogens appear to be increasing to many common used agents.Drug-sensitivity test are needed to be taken into account when empirical therapy is used for urinary tract infection.