尿路感染病原菌分布及耐药变化趋势分析

目的：分析2006—2011年尿路感染患者病原菌分布及耐药性变化趋势，为临床合理用药提供依据。方法：采用回顾性调查方法对2006～2011年尿培养分离出的668株病原菌分布进行分析，同时分析其中产超广谱β-内酰胺酶大肠埃希菌（ESBLs大肠埃希菌）分布及耐药性变化。结果：2006—2011年尿培养标本2356份，分离出病原菌668株，分离率为28．4％。其中革兰阴性杆菌438株（65．6％），革兰阳性球菌120株（18．0％），假丝酵母菌110株（16．4％）。排名前3位的是：大肠埃希菌302株（45．2％）、白假丝酵母菌57株（8．5％）、肺炎克雷伯菌47株（7．0％）。产ESBLs大肠埃希菌分离率为54．3％（164／302），各年份依次为50．0％（14／28）、51．9％（28／54）、45．6％（26／57）、45．8％（22／48）、53．1％（26／49）、72．7％（48／66）；尿路感染患者中女性多于男性（422：246）；以〉50岁为主（419／668）。结论：该地区尿路感染病原菌以大肠埃希菌为主，产ESBLs菌株分离率较高，且耐药情况严重；假丝酵母菌有较高的分离率。

The change trend analysis of the pathogenic bacteria distribution and drug resistance in urinary tract infection

Objective ：To analyze the change trend of the pathogenic bacteria distribution and drug resistance in patients with urinary tract infection so as to provide basis for the rational use of drugs in clinic. Methods： The pathogenic bacteria distribution of 668 strains isolated from a hospital and the distribution and drug resistance of extended-spectrum β-1actamase （ESBL） Escherichia coli （E. coli ） were retrospectively analyzed from 2006 to 2011. Results： Six hundred and sixty-eight strains uropathogen （the isolation rate for 28.4% ） were isolated from 2 356 urine specimens from 2006 to 2011, which included 438 strains Gram-negative bacilli （65.6%）, 120 strains Gram-positive Cocci （ 18. 0% ） and 110 stains Cadidia spp （ 16. 4% ）. E. coli was the most commonest uropathogen （302/668）, followed by Candida albicans （ 57/668 ） and Klebsiella pneumonia （ 47/668 ）. The isolation rate of ESBL ＋ E. coli was 54.3% （164/302） ,and the annual isolation rates of ESBL E. coli were 50.0% （14/28） ,51.9% （28/54） ,45.6% （26/57） ,45.8% （ 22/48 ） ,53.1% （ 26/49 ） and 72.7% （48/66） during the consecutive 6-year, respectively. The urinary tract infection in females （422 cases） were more than that in males（246 cases） ,the females with age more than 50 years were the majority（419/668）. Conclusions： The E. coli is the major uropathogen in urinary tract infection, ESBLs is high islation rate and antibiotic resistance, and the islation rate of Candida albicans is higher.