中段尿细菌培养的临床应用研究

目的探讨规范留取中段尿对尿液培养结果的重要性，男性和女性患者泌尿道感染主要致病菌的分布差异及细菌对抗生素耐药情况。方法收集佛山市中医院近一年住院和门诊病人作中段尿细菌培养病例。细菌鉴定采用法国生物梅里埃公司VTTEK—AMS细菌鉴定系统，药敏采用琼脂纸片扩散（K—B）法，调查研究住院和门诊病人采样程序；分别统计住院病人和门诊病人中段尿培养合格率、阳性结果及主要致病菌；主要致病菌的耐药情况分析。结果住院和门诊病人留取中段尿检出率分别为67％和23％。女性患者略多于男性患者。男女尿路感染均以革兰阴性杆菌为主，优势菌株均为大肠埃希菌，分别占21．83％和46.21％；感染的革兰阳性菌以肠球菌为主，以粪肠球菌和屎肠球菌最常见；真菌所占的比例亦较高，主要为白假丝酵母菌和热带假丝酵母菌；革兰阴性杆菌对甲氧苄啶、氨苄西林、庆大霉素、环丙沙星、头孢类耐药率高；革兰阳性球菌对四环素、利福平、青霉素、左氧氟沙星、环丙沙星、红霉素耐药率高；真菌对本院所选的六种药物均较敏感。结论中段尿培养应规范留取中段尿，提高标本合格率。泌尿系统感染女性略多于男性，主要痛原菌为革兰阴性杆菌，其中以大肠埃希菌为主。致病菌对多种药物耐药，临床应参照药敏结果合理用药。

The clinical application research of medistream urine bacterial culture

Objective To study the specification of urine specimens from the importance of urine culture results, to analysis the main pathogens of urinary tract infections in male and female differences in the distribution of patients and antibiotic resistance in bacteria, and to provide a reliable basis for clinical use. Methods Traditional Chinese Medicine Hospital of Foshan City, nearly a year of inpatient and outpatient urine for bacterial culture, using the French company bioMerieux VITEK- AMS bacterial identification system and agar disk diffusion （KB） method for bacterial identification and susceptibility test results to determine the 2010 version of the American Committee for Clinical Laboratory Standards （CLAB） standards. Results The inpatient and outpatient service to return middle respectively urine deteetion 67 ersus 23 %. Male patients slightly more than female patients. Male and female urinary tract infections are gram- negative bacilli, dominsnt strains were Escherichia eoli, Accounted for 21.83% and 46.21%, Consistent with the Literature; In gram - positive bacteria dominsted by Enterococcus, Enterococcus faecalis and the most common feces; a higher proportion of fungi, mainly Candida albicans and Candida tropicalia, Gram - negative bacilli to trimethoprim, ampicillin, gentamicin, ciprofloxaein, cephalosporins resistant to high; Gram- negative bscilli to prim, ampicillin, gentamicin, ciprofloxacin, ecphalosporins resistant to high. Conclusion Urine specimens from urine culture abould be dardized to improve the passing rate of specimens. Urinary tract infections women slightly outnumber men, the main pathogens were Gram - negative bacilli, of which Escherichia coli. Pathogens resistant to multiple drugs, the clinical results should refer to the implementation of rational drug susceptibility.