泌尿系感染病原菌分布及耐药性调查分析

目的 调查医院泌尿系感染病原菌的分布及耐药性,为临床治疗泌尿系感染提供依据.方法 对2008年1月-2011年4月在医院门诊及住院患者尿液培养中分离出的524株病原菌,进行鉴定和药物敏感性监测.结果 泌尿系感染病原菌以大肠埃希菌为主,占52.1％,其次为凝固酶阴性葡萄球菌占9.2％,D群肠球菌占9.0％,肺炎克雷伯菌占6.9％,真菌占4.8％,奇异变形菌占2.1％,金黄色葡萄球菌占1.5％,铜绿假单胞菌及阴沟肠杆菌各占1.3％;产ESBIs大肠埃希菌、肺炎克雷伯菌和奇异变形菌检出率分别为41.4％、47.2％和45.5％,耐甲氧西林葡萄球菌的分离率高达76.8％.结论 泌尿系感染病原菌主要以肠杆菌科细菌为主,其次为凝固酶阴性葡萄球菌和D群肠球菌;多药耐药菌的高分离率使抗菌药物的应用压力越来越大,科学合理地使用抗菌药物,最大限度地降低耐药菌的产生已成为广大医学工作者的当务之急.

Drug resistance and distribution of pathogenic bacteria causing urinary tract infections

OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing urinary system infections so as to provide bases for clinical treatment of urinary system infections.METHODS From Jan 2008 to Apr 15 2011,the identification and drug susceptibility testing were performed for 524 strains of pathogens isolated from the urine specimens obtained from the outpatients and the hospitalized patients.RESULTS Escherichia coli was the main pathogen causing urinary system infection,accounting for 52.1,followed by coagulase-negative Staphylococci(9.2%),Group D Enterococci(9.0%),Klebsiella pneumoniae(6.9%),fungi(4.8%),Proteus bacteria(2.1%),Staphylococcus aureus(1.5%),Pseudomonas aeruginosa(1.3%) and Enterobacter cloacae(1.3%);the detection rates of ESBL-producing E.coli,K.pneumoniae,and Proteus bacteria were 41.4%,47.2% and 45.5%,the detection rate of MRSA reached as high as 76.8%.CONCLUSION The main pathogen causing urinary system infections is Enterobacteriaceae,followed by coagulase-negative Staphylococci and group D Enterococci;it becomes more and more difficult to choose antibiotics due to the high isolation rate of multidrug-resistant bacteria,scientific and rational application of antimicrobial drugs to minimize the occurrence of drug resistant bacteria has become the top priority of the medical workers.