泌尿系感粢病原体分布及耐药性监测

目的:了解我院泌尿系感染病原菌的分布现状和体外耐药性,为临床提供诊断和治疗依据。方法:采用全自动微生物分析仪ATB Expression及配套试剂,对我院2005年1月1日至2006年12月31日的住院及门诊患者尿培养分离出的561株病原前进行细菌鉴定和体外耐药性监测。结果:大肠埃希菌是引发泌尿系感染的主要病原菌,占42.1%;其次为肠球菌属(14.2%)、真菌(13.7%)、凝固酶阴性葡萄球菌(9.1%)、肺炎克雷伯菌(4.5%)、奇异变形杆菌(2.9%)及铜绿假单胞菌(2.1%);大肠埃希菌和肺炎克雷伯菌产ESBLs株检出率分别为37.7%和40.0%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和高水平庆大霉素耐药肠球菌(HLGR)检出率分别为66.7%和72.5%;体外耐药监测表明:肠杆菌科细菌对碳青醇烯类保持100%敏感性,对β-内酰胺酶抑制剂复合物和阿米卡星敏感性较强(76%),对其他抗生素耐药率较高;革兰阳性球菌耐药情况也相当严重,但尚未发现耐万古霉素菌株。结论:泌尿系感染最主要病原菌为大肠埃希菌,假丝酵母菌分离率显著上升;病原菌耐药率呈上升趋势,临床医师应积极送检,根据尿培养结果合理选用抗生素进行治疗。

Survey of the Distribution and Drug Resistance of Pathogens in Urinary System Infection

Objective To investgate the distribution and drug resistance of pathogensin urinary system infection.Methods A total of 561 pathogen strains in urinary system infection from inpatients and outpatients in our hospital from Jan 2005 to Dec 2006 were identified and the drug resistance test was preformed by ATB expression.Results Among these pathogens,Ese- herichia coli rated the top one(42.1%),followed by Enterococ cus(14.2%),fungus(13.7%),coagulase negative Staphy- lococens(9.1%),Klebsiella pneumoniae(4.5%),P.mirabilis(2.9%)and Pseudomonas aeruginosa(2.1%).The inci- dence of MRCNS,HLGR,RSBL prodneing E.coli and K.pneumoni AE,were 66.7%,72.5%,37.7% and 40.0% respec- tively.The result of drug resistance suggested that Entetobacteriacea be resistantto several and ibiotics,but still sensitive to car- bapenems(100%),beta-lactamase inhibtor combinations and amikacin(≥76%).G + cocei were also,showed very serious drug resistace,but still seusilive to vancomycin(100%).Conclusion E.coli is the main infectious bacterium in urinary sys- tem infection.Rational use of antibioties should be earried out according to urine culture results.