尿路感染病原菌分布及药物敏感趋势分析

目的 了解近年尿路感染患者病原菌分布及其药物敏感变化趋势,为临床合理用药提供依据。方法 对2002年1月-2005年12月,住院患者尿培养分离出的338株病原菌进行分析及其药物敏感趋势监测。结果 尿路感染的致病菌主要为大肠埃希菌,占40.24%;其次为链球菌属、表皮葡萄球菌;2002-2005年大肠埃希菌的检出率分别为50.0%、42.9%、38.6%、34.9%,呈下降趋势,革兰阳性球菌检出率逐年增加;ESBLs确证试验结果：90株大肠埃希菌中有24株产ESBLs酶,产酶率26.67%;大肠埃希菌对喹诺酮类、庆大霉素、复方新诺明的敏感率〈30.0%,对碳青酶烯类、氨曲南、呋喃妥因的敏感率〉90.0%;呋喃妥因、万古霉素对革兰阳性球菌的敏感率较高,〉80.0%。结论 大肠埃希菌仍为尿路感染的主要致病菌,革兰阳性球菌有增加趋势,应引起高度重视;碳青酶烯类抗菌药物、氨曲南是治疗大肠埃希菌感染的首选抗菌药物。

Urinary System Infection and Drug Susceptibility Monitoring: Analysis of 338 Strains of Pathogens

OBJECTIVE To provide basis for reasonable use of drugs in clinical practice,we analyzed 338 strains of pathogens in urinary system infection and monitored their drug susceptibility.METHODS A total of 338 strains of bacteria collected from urine specimens of patients from 2002 to 2005 were identified and monitored their drug susceptibility.RESULTS Escherichia coli was the most predominant pathogen,whose isolating rate occupied 40.24%.The second was Streptococcus and Staphylococcus epidermidis.During the four years the isolating rate of E.coli was 50.0%,42.9%,38.6%,and 34.9%,respectively,indicating a downtrend,but G+ cocci increased during the same time.The incidence of ESBLs in 90 E.coli strains was 26.67%.The sensitivity of E.coli to quinolones,gentamicin and TMP-SMZ was lower than 30.0%,but to carbopenems,aztreonam and furantoin was higher than 90.0%.Furantoin and vancomycin were sensitive to G+ cocci,whose susceptibility was over 80.0%.CONCLUSIONS E.coli is still the most predominant pathogen,G+ cocci are increasing gradually.Carbopenems and aztreonam are the first choice for treating E.coli infection.Furantoin and vancomycin are the first choice for treating G+ cocci infection.We should reasonably use antibiotics in accordance with drug susceptibility.