1233份尿样病原菌分布和耐药性分析

目的调查我院2013年送检的中段尿培养结果及药敏状况,以期对临床诊断和治疗用药提供参考。方法采用法国梅里埃公司VITEK 2Compact型全自动微生物鉴定仪进行细菌和真菌鉴定及药敏试验。结果 1 233份中段尿标本中,检出病原菌421株,阳性率为34.1%,以细菌为主占79.8%(336/421),真菌占20.2%(85/421)。大肠埃希菌为中段尿感染最常见菌占35.9%(151/421),革兰阴性菌对头孢类药物耐药性很高,而对亚胺培南和美罗培南的敏感性较好,革兰阳性菌中以肠球菌为主,主要为屎肠球菌和粪肠球菌,对万古霉素和替加环素敏感,屎肠球菌对青霉素、红霉素及喹诺酮类耐药率较高,而粪肠球菌对青霉素及四环素耐药率较高,真菌感染亦不容忽视。结论尿培养分离的病原菌种类较多,耐药率较高,应加强尿培养监测,依据药敏试验结果合理选用抗菌药,避免耐药菌株的产生。

Analysis of distribution and drug resistance of pathogens in 1233 urine samples

Objective To investigate urine culture results and drug sensitivity status in 2013,in order to provide the reference for clinical diagnosis and treatment.Methods The bacteria and fungus identification and antimicrobial susceptibility were assayed by automatic bacteria culture device VIVEK 2Compact from bio Mrieux company.ResultsIn 1 233urine samples,421strains of pathogenic bacteria were detected,the positive rate was 34.1%,the bacteria accounted for 79.8%（336/421）,fungi accounted for 20.2%（85/421）.Escherichia coli for urine infection was the most common bacteria which accounted for 35.9%（151/421）,gram negative bacteria showed very high resistance to cephalosporins,but very sensitive to imipenem and meropenem,gram positive bacteria with Enterococcus,mainly for Enterococcus faecium and Enterococcus faecalis,both sensitive to vancomycin and tigecycline,Enterococcus faecium to penicillin,erythromycin and quinolone resistance rates were very high,but resistance rate of Enterococcus faecalis to penicillin and tetracycline were very high,Fungal infection could not be ignored,too.Conclusion Many kinds of pathogenic bacteria separation of urine culture were involved,drug resistance rate was high,the monitoring based on urine culture should be strengthened.According to the result of drug sensitivity test,antibacterial drugs should be in rational use,avoiding drug resistant strains.