导尿管相关性尿路感染的病原菌分布及耐药性

目的 了解妇科手术患者留置导尿管相关性尿路感染(CAUTI)的病原菌谱及对常用抗菌药物的耐药性.方法 对2009年1月-2010年12月留置导尿管相关性尿路感染的89例妇科患者进行尿液细菌学培养,菌株鉴定采用法国生物梅里埃公司的VITEK-60分析仪,药敏试验采用K-B法.结果 89例患者尿液中分离出病原菌103株,以革兰阴性菌为主,占64.08％；革兰阳性菌占 30.10％,真菌占5.82％,其中大肠埃希菌最多见,占38.84％,其次为粪肠球菌、表皮葡萄球菌,分别占15.54％、10.68％；大部分细菌对青霉素及第一、二代头孢菌素产生耐药性.结论 妇科患者导尿管相关性尿路感染以革兰阴性菌为主,应合理使用抗菌药物,尽量减少留置导尿管时间.

Distribution and drug resistance of pathogens causing catheter-related urinary tract infections

OBJECTIVE To understand the spectrum of the pathogens causing catheter-related urinary tract infections(CAUTI) in the gynecological surgery patients and the drug resistance to common antibiotics.METHODS From Jan 2009 to Dec 2010,a total of 89 gynecological surgery patients with CAUTI were selected for urine bacteriology culture,the identification of the bacteria strains was performed with VITEK-60 analyzer of BioMérieux,France,and the drug susceptibility testing was performed by K-B method.RESULTS A total of 103 strains of pathogens were isolated from the urine of 89 patients,including gram-negative bacteria(64.08%),gram-positive bacteria(30.10%),and fungi(5.82%);Escherichia coli isolates were the most common,accounting for 38.84%,followed by Enterococcus faecalis(15.54%) and Staphylococcus epidermidis(10.68%);most bacteria were resistant to penicillin and the first and second generation cephalosporins.CONCLUSION Gram-negative bacteria are the major pathogens causing CAUTI in gynecological surgery patients,it is necessary to use antibiotics reasonable and make the indwelling catheter duration shortened as much as possible.