尿路感染病原菌的耐药性

目的探讨尿路感染病原菌和耐药性的变化。方法分析2001-2003年750例尿液培养阳性的尿路感染病原菌分布及其对抗菌药物敏感性。结果革兰阴性杆菌占53.60%,其中大肠埃希菌占38.13%;革兰阳性球菌占35.20%,其中肠球菌属占16.53%;真菌占11.20%;大肠埃希菌对氨苄西林耐药率最高,达80.54%;对氨苄西林/舒巴坦耐药率也较高,达57.69%,对阿米卡星的耐药率明显低于庆大霉素(P<0.01),对喹诺酮类耐药率为45.00%~71.00%,对萘啶酸耐药高达71.23%,对复方新诺明耐药率达65.14%。结论大肠埃希菌仍是尿路感染的主要病原菌,但肠球菌属、克雷伯菌属、铜绿假单胞菌等病原菌比例有所增加,这些病原菌耐药性高,尤其对喹诺酮类、氨苄西林、萘啶酸、复方新诺明耐药性高,而且部分病原菌呈多重耐药,应注意根据药敏试验调整用药。

New Resistant Tendency of Urinary Tract Infection

OBJECTIVE To explore urinary tract infection.METHODS Totally 750 clinical isolates of urinary tract infection were collected from patients who were cured in our hospital from 2001 to 2003,then analyzed the kinds of these bacterials and sensitive rate to antibiotics.RESULTS The percentage of Gram-negative bacilli was 53.60%,in which Escherichia coli was 38.13%;The percentage of Gram-positive cocci was 35.20%,in which Enterococcus were 16.53%;the percentage of fungi was 11.20%.The resistance rate of Escherichia coli to ampicillin,amoxicillin/clavulanic acid,quinolones,nalidixic acid and SXT was 80.54%,57.69%,45.00-71.00%, 71.23% and 65.14%,respectively,and the resistance rate to amikacin was lower than to gentamicin(5.82% vs 39.11%,P<0.01).CONCLUSIONS The most kind of bacteria in urethral infection is E.coli,and the resistance rate of Enterococcus,Klebsiella,and Pseudomonas aeruginosa is increasing.The resistance rates of these bacteria to antibiotic are high,especially to quinolones,ampicillin,nalidixic acid and SXT, some are multidrug resistant,so we should pay more attention to control it.