泌尿系感染菌谱及耐药性分析

目的：探讨泌尿系感染患者细菌分布及耐药性，指导临床医生合理用药。方法：通过Kirby—Bauer法及超广谱母内酰胺酶（ESBLs）的检测对泌尿系感染患者分离获得的380株病原菌的分布及耐药性进行分析。结果：380株细菌，革兰阴性菌272株（71．6％）。革兰阳性菌108株（28．4锄。居前5位的病原菌依次为：大肠埃希菌190株（50．O％）、金黄色葡萄球菌42株（11．1％）、表皮葡萄球菌34株（8．9％）、粪肠球菌22株（5．8％）、阴沟肠杆菌20株（5.3％）。革兰阴性菌与革兰阳性菌对多种抗生素均有较高的耐药率，但前者对亚胺培南较敏感（94．4％），后者对万古霉素、替考拉宁敏感（100．0％）。产ESBLs大肠埃希氏菌株达38．8％，其对多种抗生素的耐药性明显高于非产酶株。结论：引起泌尿系感染的细菌谱尽管很广泛，但仍以革兰阴性菌为主，大肠埃希菌最常见达50％，其产ESBLs菌株的耐药性明显高于非产酶株，提示泌尿系病原菌的ESBLs监测对指导临床医生合理使用抗生素具有非常重要的意义。

Drug resistance of pathogens in urinary System infection

Objective:To know the present status and drug resistance of pathogens in urinary system infection.Methods:A total of 380 pathogen strains in urinary system infection from inpatients and outpatients from 2001 to 2004 were identified. The drug resistance test was preformed by Kirby-Bauer method.The ESBLs-preducing Escherichia coli was detected.Results:Escherichia coli rated the top one(50.0%),the next was Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Enterobacter cloacae, Klebsiella pneumoniae. The result of drug resistance suggested that gram-negative and gram-positive bacteria were resistant to several antibiotics,but the former was still sensitive to imipenem (94.4%),the latter still sensitive to teicoplanin and vancomycin (100.0%). Drug resistance of ESBLs-producing E.coli was more serious than that of non- ESBLs-producing strains to 11 antibitics.Conclusion:E.coli is the main pathogen in urinary infection. Rational use of antibiotics should be carried out according to urine culture results.