尿路感染642例病原菌分布及耐药性分析

目的了解泌尿系统感染的病原菌分布及耐药情况,指导临床合理用药。方法对2012年1月—12月我院中段尿培养标本中分离的642株致病菌及其药敏试验结果进行回顾性分析。结果从1 507份临床送检标本中共分离出642株病原菌(同一患者只取第1株),其中G-杆菌共420株,占65.4%;G+球菌178株,占27.7%;真菌44株,占6.8%。排列在前6位的病原菌分别为大肠埃希菌、粪肠球菌、肺炎克雷伯菌、屎肠球菌、表皮葡萄球菌和铜绿假单胞菌。检出产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌、肺炎克雷伯菌共192株,阳性率分别为60.2%和36.2%。发现对亚胺培南耐药的大肠埃希菌2株;对万古霉素耐药的屎肠球菌1株。结论泌尿系统感染的病原菌以G-杆菌为主,病原菌多重耐药现象严重;临床医师应重视中段尿培养,并应根据药敏试验结果合理选择抗生素。

Pathogens detection and drug-resistance analysis in 642 patients with genitourinary tract infections

Objective To provide reference for proper clinical application through the study of the distribution and resistance of pathogenic bacteria in urinary tract infection.Method Distribution and antibiotics sensitivity test of pathogens isolated from the middle segment urine culturing specimens collected from a part of clinical department from January to December 2012.Result 642 pathogenic strains were isolated from 1507 detected specimens（taking the first strain in the same patient）,including 420 strains of Gram-negative bacteria,which counted for 65.4%;178 strains of Gram-positive bacteria,which counted for 27.7%;44 strains of fungi,which counted for 6.8%.Pathogenic bacteria arranged in the top six were E.coli,E.faecalis,K.pneumonia,E.faecium,S.epidermidis and P.aeruginosa.ESBLs-producing E.coli and K.pneumonia were in 192 strains with the positive rate of 60.2% and 36.2% respectively.2 isolates of E.coli were found resistant to impenem and 1 isolate of E.faecium was found resistant to vancomycins.Conclusion The pathogens of urinary tract infection are mainly Gram-negative bacteria and the detected bacteria have a serious resistance to antibacterial agents.Doctors should pay attention to bacteria culturing and antibacterial agents should be selected according to the drug sensitive tests.