泌尿系感染病原菌的分布及耐药性分析

目的探讨泌尿系感染病原菌的分布及耐药性,为临床合理选用抗菌药物提供依据。方法对2013年1月~2014年12月送检的尿标本进行病原菌培养、分离及鉴定,用纸片扩散法、E-test法或全自动细菌分析仪测定细菌对不同抗菌药物的敏感性,采用2013年版CLSI标准判读结果。结果共分离出4 027株病原菌,其中革兰阴性菌占66.4%,革兰阳性菌占25.7%,真菌占7.9%。检出率最高的前4位病原菌依次为大肠埃希菌、屎肠球菌、肺炎克雷伯菌和粪肠球菌。大肠埃希菌对亚胺培南和美罗培南最为敏感,对青霉素类耐药性最强。肠球菌属的整体耐药性十分严重,屎肠球菌比粪肠球菌的耐药率高,二者对万古霉素和利奈唑胺较为敏感。结论泌尿系感染病原菌对抗菌药物已产生了一定的耐药性,定期监测尿路感染病原菌的分布及耐药性,对指导临床合理用药具有重要意义。

Distribution and drug resistance of pathogens causing urinary tract infections

Objective To investigate the distribution and drug resistance of pathogenic bacteria causing urinary tract infections so as to provide guidance for reasonable clinical use of antibiotics .Methods Urine samples from outpatients and inpatients admitted dur‐ing Jan .2013 to Dec .2014 were used for bacterial culture and isolation .The isolates were identified by using automatic bacteria analyzer .The drug susceptibility of bacteria was tested by using Kirby‐Bauer test ,E‐test or automatic bacteria analyzer according to the manual of Clinical and Laboratory Standards Institute (CLSI ,2013) .Results A total of 4 027 strains of pathogenic were col‐lected ,which included Gram‐negative bacilli (66 .4% ) ,Gram‐positive cocci (25 .7% ) and f ungi (7 .9% ) .E .coli remained high susceptibility to imipenem and meropenem ,but was highly resistant to penicillin .The drug resistance of Enterococcus was pretty serious ,in which the resistance rate of Enterococcus f aecium was higher than that of Enterococcus f aecalis .However ,both of them remained highly susceptible to vancomycin and linezolid .Conclusions Pathogenic bacteria causing urinary tract infections showed certain resistance to antibiotics .Regular investigation of the distribution and drug resistance of pathogens causing urinary tract in‐fections is important for guiding the reasonable clinical use of antibiotics .