尿路感染病原菌分布及抗菌药物耐药性

目的探讨尿路感染的病原菌分布特点及细菌耐药现状,为临床合理使用抗菌药物提供依据。方法收集2005年3月-2006年6月,清洁中段尿培养分离的病原菌并作细菌药敏及耐药性分析。结果共收集致病菌438株,前5位细菌依次为大肠埃希菌(ECO)220株(50.2%)、肠球菌属(ECN)63株(14.4%)、金黄色葡萄球菌(SAU)38株(8.7%)、肺炎克雷伯菌(KPN)32株(7.3%)、奇异变形菌(PMI)17株(3.9%);ECO、KPN、PMI对氨苄西林(AMP)、复方新诺明(SXT)、喹诺酮类药物呈高度耐药(70.6%~100.0%);ECO、KPN产超广谱β-内酰胺酶(ESBLs)率分别为41.4%、31.3%;ECN对青霉素、喹诺酮类药物耐药严重(81.0%~96.8%),庆大霉素高水平耐药(HLGR)ECN占79.4%;耐甲氧西林金黄色葡萄球菌(MRSA)占78.9%。结论我院尿路感染常见病原菌耐药严重,应及时检测病原菌及其耐药情况,以便合理使用抗菌药物。

Pathogens and Antibiotic Resistance Analysis in Urinary Tract Infection

OBJECTIVE To investigate the bacterial distribution and antibiotic resistance situation with urinary tract infection(UTI) for the guidance of rational use of antibiotics.METHODS The antibiotic resistance of clinical isolates from urinary tract infection from Mar 2005 to Jul 2006 was analyzed. RESULTS The most common pathogens in urinary tract infection were Escherichia coli(50.2%),Enterococcus(14.4%),Staphyloccus aureus(8.7%),Klebsiella pneumoniae(7.3%),and Proteus mirabilis(3.9%).E.coli,K.pneumoniae,and P.mirabilis were found to be highly resistant to ampicillin,quinolones and SMZ(70.6-100.0%).Enterococcus were highly resistant to penicillin and quinolones(81.0-96.8%).41.4% of E.coli and 31.3% of K.pneumoniae isolates produced ESBLs.HLGR-Enterococcus were 79.4%.78.9% S.aureus isolates were resistant to oxacillin.CONCLUSIONS The high antibiotic resistance of commonly encountered pathogens is a serious problem and much attention should be paid to detect pathogens and their antibiotic resistance.