尿路感染病源菌分析及耐药性调查

[目的]了解医院尿路感染病源菌分布及其耐药性，为临床用药提供依据。[方法]按照常规培养方法分离病源菌，采用法国生物梅里埃API鉴定系统和Kirby—Bauer琼脂扩散法对病源菌进行鉴定及药物敏感试验并应用WHONET5．5软件分析细菌分布和耐药性。[结果]930株尿路感染主要病源菌中革兰阴性杆菌574株占61．7％，革兰阳性球菌234株占25．2％。耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）分别为8．5％和10．3％。真菌122株占13．1％。大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶（ESBLs）株分别为19．8％和14．7％。[结论]大肠埃希菌是尿路感染的主要病原菌，真菌感染及细菌多重耐药是我院面临的重要问题，临床上应根据体外药敏结果选择抗菌药物，控制耐药菌株的产生。

Analysis of distribution and drug resistance of pathogens in urinary infection

[ Objective ] To understand the present status and drug resistance of pathogens in urinary system infection, in order to provide evidence for clinical rational drug utilization. [ Methods] Pathogen strains were isolated by traditional methods and identified by API appraisal system. Drug resistance test was performed by Kirby - Bauer method and analyzed by WHONET5.5. [ Results ] Among the 930 pathogen strains, Gram negative organisms accounted for 61.7%, Gram positive cocci accounted for 25.2%. MRSA and MRCNS accounted for 8.5% and 10.3% respectively. 122 strains of fungi accounted for 13.1%. Extended - spectrum 13-lactamases （ ESBLs ） were found 19.8% and 14.7% in E. coli and Klebsiella respectively. [ Conclusion] Pathogens in urinary infection were intestinal bacilli, with predominance of E. coll. Fungus infection and rnultidrug resistance are the main risk factors. The clinic should choose antimicrobial agents rationally according to drug sensitive tests in vitro.