基层医院尿路感染病原菌耐药性调查

目的调查基层医院尿路感染病原菌的耐药现状，为临床治疗提供依据。方法对2011-01～2011-12该院门诊、急诊和住院尿路感染患者尿液标本中分离出的316株病原菌进行鉴定和药敏试验。结果尿路感染以革兰阴性杆菌为主，占73.7％，其中以大肠埃希菌占最大比例，为41.8％，其次是肺炎克雷伯菌、阴沟肠杆菌，分别为11.1％、5.1％；革兰阳性球菌占16.8％，其中以肠球菌和凝固酶阴性葡萄球菌多见，分别为10.1％、5.1％；真菌占9.5％，以假丝酵母菌为主。革兰阴性杆菌对碳青霉烯类、哌拉西林/他唑巴坦和阿米卡星有较高的敏感性；革兰氏阳性球菌对糖肽类抗菌药物呈100.0％敏感；假丝酵母菌对常用抗真菌药物敏感性较好。结论尿路感染主要以肠杆菌科为主要致病菌，且具有较高的耐药性；经验用药前应积极进行病原学检查和药敏试验，以指导尿路感染的的合理用药，减少耐药菌的产生和传播。

Investigation of drug resistance of pathogens causing urinary tract infection in grass-roots hospital

Objective To investigate the drug resistance of pathogens causing urinary tract infection in grass-roots hospital,so as to provide evidence for clinical management .Methods From Jan.2011 to Dec.2011, a total of 316 strains of pathogens were isolated from urine specimens of inpatients and outpatients in the People ′s Hos-pital of Hengxian ,and drug sensitivity test was performed .Results The predominant pathogens of urinary tract infec-tions were gram-negative bacteria , accounted for 73.7%, in which Escherichia coli ranked the first （ 41.8%） , fol-lowed by Klebsiella pneumoniae （ 11.1%） and Enterobacter cloacae （ 5.1%） .Gram-positive bacteria accounted for 16.8%, in which Enterococcus and coagulase negative staphylococcus were common , accounted for 10.1%, 5.1%, respectively .Fungi accounted for 9.5%, in which Candida were the majority .In these isolated pathogenic bacteria , gram-negative bacterial were sensitive to carbapenems ,piperacillin/tazobactam and amikacin .The sensitivity rate of gram-positive bacteria to glycopeptides antibiotics were high .Candida were sensitive to common antifungal agents . Conclusion Enterobacteriaceae was the major pathogens causing urinary tract infection , and had higher degree of drug resistance rate .Etiological examination and drug sensitivity test of pathogens of urine should be performed before initiation antibiotics treatment for urinary tract infection , so as to guide the reasonable use of antibiotics and reduce the generation and dissemination of drug-resistant.