导尿管相关尿路感染生物被膜菌及药敏结果分析

目的了解九江地区近2年来导尿管插管后患者尿路感染的病原菌构成,细菌耐药性和生物被膜形成情况,以便指导临床合理用药。方法于2009年8月至2011年8月选择我院住院部收治的CAUTI患者145例为对象,对其导尿管进行细菌培养,药敏试验和细菌生物被膜的检测。结果共分离出118株生物被膜菌,检出率81.4%;以大肠埃希菌为主,占46.61%;大多数生物被膜菌株有较厚的生物被膜;革兰阴性菌中大肠埃希菌等对β-内酰胺类抗生素有很高的耐药率,对阿米卡星的耐药率较低,大肠埃希菌和肺炎克雷伯菌对亚胺培南敏感率为100%。革兰阳性球菌的耐药情况也相当严重。结论针对大多数生物被膜菌株有较厚的生物被膜,要选择细菌生物被膜敏感的抗菌药物,根据菌株的药敏试验,合理地制定治疗方案,以便控制感染。

Study on biofilms and drug sensitivity of catheter-associated urinary tract infection bacteria

Objective To investigate the composition,biofilm formation and drug sensitivity of the bacteria isolated from patients with CAUTI,and to instruct application of antibiotics reasonably.Method Catheters of 145 inpatients with CAUTI from AUG 2009 to AUG 2011 were cultured,and drug resistance and biofilm were tested.Result One hundred and eighteen strains（81.4%） of bacteria were detected producing biofilm,and the major constituent were Escherichia coli（46.61%）.Most of bacteria produced a thick biofilm.Escherichia coli were extremely resistant to β-lactam antibiotics and sensitive to amikacin.All Escherichia coli and Klebsielal pneumoniae stains were sensitive to Imipenem.Gram-positive cocci were resistant to the other antibiotics.Conclusions Bacterial biofilms sensitive antibiotics should be selected in bacterial strains with a thick biofilm and reasonable treatment should be made by drug sensitivity test to control the infection.