泌尿系感染病原菌菌种分布及耐药性分析

目的探讨泌尿系感染患者病原菌的分布及耐药性，为我院临床诊断和合理用药提供帮助和指导。方法收集我院2008年1月至2009年12月门诊和住院泌尿系感染患者的中段尿标本。常规方法培养，采用德国西门子生产的Walk Away40SI微生物药敏鉴定测试系统对分离出的295株病原菌进行菌种鉴定及耐药性分析。结果分离出的295株病原菌，革兰阴性菌204株（69．2％），革兰阳性菌67株（22．7％），真菌24株（8．1％）。居前五位的病原菌依次是大肠埃希菌150株（50．8％），肠球菌30株（10．2％），凝固酶阴性葡萄球菌24株（8．1％），变形杆菌12株（4．1％），肺炎克雷伯菌12株（4．1％）。体外耐药监测表明：肠杆菌科细菌对碳青酶烯类保持100％敏感性，对阿米卡星和呋喃妥因敏感性较强，对其他抗生素耐药率较高；革兰阳性球菌的耐药情况也相当严重。结论泌尿系感染最主要的病原菌为大肠埃希菌，病原菌耐药性严重且多重耐药，一临床医师应积极送检，根据尿培养结果合理选用抗生素进行治疗。

Distribution and drug resistance of pathogenic bacteria from urinary tract infection

Objective To investigate the distribution of pathogens and drug resistance in patients with urinary tract infection. It provides help and guidance to our hospital for clinical diagnosis and rational use of drugs. Methods Urinary urine samples of our outpatient and inpatient patients（January 2008 -December 2009） with urinary tract infection were collected. Conventional method of cultivation, production by the German Siemens Walk Away40SI microbial susceptibility test system for identification and drug resistance of 295 strains of pathogens isolated from the strain identification. Results Two hundred and ninety -five strains of pathogens were isolated, Gram -negative bacteria 204（69.2% ） ,Gram- positive bacteria 67 （22. 7% ） ,24 strains of fungi（8.1% ）. The top five pathogens followed by Escherichia coil 150 （ 50. 8% ） , Enterococcus 30 （ 10. 2% ） , 24 strains of coagulase - negative staphylococci （8. 1% ）, Proteus 12 （ 4. 1% ）, KlebsieUa pneumoniae 12 （4. 1% ）. Drug Resistance shows that ： Enter- obactreiaceae remains 100% sensitivity to Carbapenems, strong sensitivity toamikacin nitrofurantoin,high resistance to other antibiotics;resistant in gram -positive cocci situation is very serious. Conclusions The most important pathogen of urinary tract infection, Escherichia coli, is a serious pathogen resistance and multidrug resistance, clinicians should inspect actively and use antibiotics rationally according to the results of urine culture.