泌尿系感染病原菌分布及耐药性分析

目的 探讨我院常见泌尿系感染病原菌分布及对抗生素的耐药性,以指导临床合理用药.方法 收集我院泌尿系感染患者尿标本分离出的262株病原菌,采用美国MICROSCANAS-4细菌鉴定及药敏分析系统进行鉴定及药敏试验.结果 泌尿系感染主要病原菌前5位依次为:大肠埃希菌82株(31.30%),真菌65株(24.81%),肠球菌(粪肠球菌21株,8.02%;屎肠球菌14株,5.34%),肺炎克雷伯菌22株(8.40%),阴沟肠杆菌21株(8.02%),产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的检出率分别为26.83%,50%.除真菌外5种主要病原菌的药敏结果表明:大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对泰能保持较高的抗菌活性,对其他的抗生素,后两者耐药分别＞54%和80%,大肠埃希菌对氨苄西林、头孢噻吩的耐药高达82.93%和81.82%;肠球菌对万古霉素保持100%敏感性.结论 泌尿系感染最多见的是大肠埃希氏菌,真菌性尿路感染明显增多,病原菌耐药严重,临床医生应重视尿培养检测,根据药敏报告合理地选用抗菌药物治疗.

Analysis of bacteria distribution and their drug resistance in urinary system infection

Objective From the study of bacteria distribution and their resistance to antibiotics in urinary system normal infection of our hospital,we can give guidance to the clinical doctor to select rational drug.Methods Collecting 262 strains pathogens from the urine of the patients with urinary system infection in our hospital,we identified the pathogens and had sensitive drugs test by American Microscan AS-4 analys's system of bacteria identification and drug sensitivity system.Results From the first to the fifth of the main pathogens in urinary system infection are 82 strains(31.30%) of Escherichia coli,65 strains(24.80%) of Fungus,21 strains(8.02%) of Enterococcus faecalis,14 strains(5.34%) of Enterococcus faecium,22 strains(8.40%) of Klebsiella pneumoniae,21 strains(8.02%) of Enterobaeter cloacae.The detectived rate of ESBLs Escherichia coli and Klebsiella pneumoniae are 26.83% and 50.00%.The tests of drug sensitivity in the main pathogens except Fungus included that Escherichia colis Klebsiella pneumoniae and Enterobacter closcae are more sensitive to imipenem,the latter have high drug resistance to other antibiocs,the rates are 54% and 80%,the rates of drug resistance of Escherichia coli to Ampicillin and Cephalothin are 82.93% and 81.82%,and that of Enterococcus to Vancomycin is 100%.Conclusion Escherichia coli are most often seen in urinary tract infection,Fungus are more often seen than before.Obviously,drug resistance are serions,clinical doctor should pay attention to result of cultured urine,and make a good choice of antibiotics from the drug sensitive test.