1126例尿路感染的病原菌分布及药物敏感性分析

目的了解本院近年尿路感染的病原菌分布及药物敏感情况，为临床合理用药提供依据。方法对我院2010年8月至2013年4月分离出的l125株病原菌的分布情况进行统计，并对常见的致病菌株进行药物敏感性分析。结果尿路感染以大肠埃希菌检出率最高，为52．80％，其后依次为肠球菌属（13．07％）、克雷伯菌属（7．02％）、铜绿假单胞菌（4．62％）。大肠埃希菌和肺炎克雷伯菌ESBLs检出率分别为45．1％和34．5％。分离的病原菌中排列前四位的革兰氏阴性杆菌对亚胺培南最敏感，对阿米卡星、哌拉西林／他唑巴坦也有较高敏感性。排列前四位的革兰氏阳性球菌对万古霉素敏感性为100％。结论大肠埃希菌仍为尿路感染最常见的病原菌，病原菌菌谱分布广，敏感的药物较少，多重耐药严重。临床应该高度重视标本的送检及根据药敏报告合理使用抗生素，不滥用抗生素，减少耐药株的产生。

Distribution and antibiotics susceptibility analysis of pathogens in 1 119 cases of urinary tract infection.

Objective To analyze the distribution and antibiotics susceptibility of pathogens in urinary tract infection and provide experience to reasonable clinical usage of anfibacterials. Methods The distribution and antibiotic susceptibility of 1 119 pathogens collected in our hospital from January 2010 to August 2012 were analyzed. Results Escherichia coli was the most prodominant pathogen with a percentage of 52.73%, followed by Enterococcus （13.05%）, Klebsiella （7.06%） and Pseudomonas aeruginosa （4.65%）. The incidence of ESBLs in was 45.1% in E. coli and 34.5% in Klebsiella pneumoniae. The most sensitive antibiotics to the first grade of four species of gram-negative was carbopenems, and the most sensitive antibiotics to the first grade of four species of gram-posi- tive was vancomyin （100%）. Conclusion E. coli is the most predominant pathogen of urinary tract infection, with wide dis- tribution, less sensitive antibiotics, and severe multidrug resistance. The clinical staffs should pay more attention to the test of the samples and the reasonable use of antibiotics with drug susceptibility for decreasing the resistant strains.