845例尿路感染患者菌群分布及耐药性分析

目的 分析尿路感染患者病原菌的分布特点及耐药现状,为临床合理使用抗菌药物提供依据.方法 细菌鉴定采用法国生物梅里埃公司VITEK32细菌鉴定系统及配套试剂.药敏试验采用纸片扩散法(K-B法),结果按CLSI2010年版标准判读,用WHONET 5.4软件进行耐药性分析.结果 845例分离菌株中,革兰阴性杆菌占61.8%(522/845),革兰阳性球菌占29.6%(250/845),真菌占8.6%(73/845).大肠埃希菌是尿路感染的主要致病菌,占35.3%(298/845),其次为肠球菌,占20.9%(177/845).大肠埃希菌和肺炎克雷伯菌产ESBLs检出率分别为68.8%和49.1%,发现碳青霉烯类抗菌药物耐药的肠杆菌科细菌.检出万古霉素耐药的粪肠球菌5株和屎肠球菌2株.结论 大肠埃希菌仍是尿路感染的主要病原菌,碳青霉烯类耐药的肠杆菌科细菌和VRE的感染应引起重视.

Analysis of distribution and resistance to antibiotics of pathogens in 845 patients with genitourinary tract infections

Objective To investigate the distribution characteristic and drug resistance status in pathogens isolated from infected urinary tract in Haikou People Hospital and offer the scientific evidence for reasonable usage of antibiotics.Methods Identification of bacteria using the French bio-Merieux VITEK32bacterial identification system and related reagents.Antibiotic susceptibility testing by agar disk diffusion ( K-B ) method , carried out in MH agar plates , and the results were read under the standard of CLSI in 2010.The data were analyzed by WHONET 5.4software.Results Of the 845clinical isolates , gram-negative bacilli accounted for 61.8% ( 522 / 845 ), gram-positive bacilli accounted for 29.6% ( 250 / 845 ), fungus accounted for 8.6% ( 73 / 845 ) .The chief pathogenic bacteria in urinary tract infection is E.coli , which accounted for 35.3% ( 298 / 845 ), secondly , Enterococcuses , accounted for 20.9% ( 177 / 845 ) .ESBLs-producing rate in E.coli is 68.8%and in K.pneumoniae is 49.1% , Carbopenems-resistant bacteria was found in Enterobacteriaceae.5isolates of Enterococcus faecalis and 2isolates of Enterococcus faecium were found resistant to vancomycins. Conclusion Gram-negative bacteria is the main pathogens in urinary tract infections.Clinicians must pay attention to the infection which caused by Carbopenems-resistant Enterobacteriaceae and VRE.