泌尿系感染的病原菌分布及耐药性分析

目的研究泌尿系感染的病原菌分布及耐药性分析,为临床合理应用抗菌药物提供依据。方法应用BD Phoenix 100细菌分析鉴定仪对236株感染病原菌进行鉴定和药敏分析。对大肠埃希菌和肺炎克雷伯菌进行产超广谱β-内酰胺酶(ESBLs)菌检测。结果 236株病原菌中革兰阴性杆菌123株(52.1%),革兰阳性球菌86株(36.4%),真菌27株(11.4%)。在所有分离菌中,大肠埃希菌89株,占37.7%;其余依次为粪肠球菌43株(18.2%);真菌27株(11.4%);屎肠球菌菌25株(10.6%);铜绿假单胞菌19株(8.1%);金黄葡萄球菌11株(4.7%)等。药敏结果显示,革兰阴性杆菌对美洛培南和亚胺培南的敏感性最高,耐药率分别为0.4%和1.2%,对氨苄西林耐药率高达92.8%。结论大肠埃希菌在泌尿系感染中仍占绝对优势,革兰阴性菌和真菌检出率明显增多。泌尿系感染病原菌的耐药情况比较严重,合理使用抗菌药物非常重要。

Analysis of pathogenic bacterial distribution and drug resistance in urinary system infection

Objective To investigate the pathogenic bacterial distribution and drug resistance in urinary system infection so as to provide basis for clinic selection of antibiotics.Methods A total of 236 strains of pathogenic bacterium of urinary system infection were identified and tested drug sensitivity with BD Phonix 100 analyzer.Extended spectrum β-lactamases（ESBLs） producing test was applied in the detection of Escherichia Coli and Klebsiella Pneumoniae.Results 123 strains of Gram-negative bacillus and 86 strains of Gram-positive（36.4%） coccus were detected.The six most sensitive species were Escherichia coli（n=89,37.7%）,Enterococcus faecalis（n=43,18.2%）,fungus（n=27,11.4%）,Enterococcus faecium（n=25,10.6%）,Pseudomonas aeruginosa（n=19,8.1%）and Staphylococcus aureus（n=11,4.7%）.The drug resistance rate of the strains of Gram-negative bacillus to meropenem and imipenem were 0.4% and 1.2% respectively,while to ampicillin was 92.8 %.Conclusion Escherichia coli is the major source of pathogen of urinary infection.The ratio of Gram positive bacteria and fungi increases significantly.The resistances of most pathogenic are severe,which means the reasonable selection of antibiotics is very important.