医院感染病人中段尿和血液中病原菌的种类及耐药性分析

目的了解医院感染病人中段尿和血液中分离细菌和念珠菌的种类及耐药性，为合理使用抗生素提供依据。方法大多数分离细菌的鉴定和药敏试验利用BD Phoenix仪，少数利用手工和K—B法鉴定。念珠菌利用显色平板分离和鉴定，K—B法药敏。结果分离于中段尿的1063株病原菌中最常见的是大肠埃希菌（39．6％）、粪肠球菌（9．2％）、肺炎型肺炎克雷伯菌（8．2％）、念珠菌属（11．6％）；G-杆菌中耐药率低于30％的为美洛培南、亚胺培南、头孢哌酮／舒巴坦、阿米卡星、头孢他啶和哌拉西林／他唑巴坦；G＋球菌中万古霉素和替考拉宁的敏感率均为100％：念珠菌中两性霉素B和制菌霉素的耐药率均为0，对其他药物也均低于10％。分离于血液的543株病原菌中最常见的是大肠埃希菌（16．6％）、凝固酶阴性葡萄球菌（16．4％）、铜绿假单胞菌（11．6％）、肺炎型肺炎克雷伯菌（8．3％）和金黄色葡萄球菌（7．6％）；G-杆菌中耐药率低于30％的为美洛培南、亚胺培南、头孢哌酮／舒巴坦、阿米卡星、哌拉西林／他唑巴坦、头孢他啶和氨曲南；G＋球菌中万古霉素和替考拉宁的敏感率均为100％。结论应重视对怀疑泌尿系感染和败血症的病人进行细菌真菌培养鉴定及药敏试验，以合理使用抗生素。

Distribution and Drug Resistance of Clinical Bacterial and Candida Isolates from Midstream Voided Urine and Blood of Nosocomial Infection Cases

Objective To investigate the distribution and occurrence of drug resistant clinical bacterial and candida isolates from midstream voided urine and blood of nosocomial infection cases. Method Bacterial isolates were mainly identified using the automated BD Phoenix. A few bacterial isolates were identified by conventional and K-B method. Candida isolates were identified by color display plate and by K-B method. Data were analyzed using. Result The major species from 1063 isolates were E.coli（39.6%）, E.fecalis（9.2%）, K. pneumoniae （8.2%）, and genus Candida （11.6%）. Among the Gram negative isolates, the rate of drug resistance （meraopenem, Imipenem, Cefoperazone/Sulbactam, Amikacin, Ceftazidime, and Piperacillin/Tazobactam） was below 30%. All Gram-positive isolates were sensitive to Vancomycin and Teicoplanin. All Candida isolates were sensitive to Amphotericin B and Nystain. The resistance of Candida to other drugs was below 10%. The major species in 543 isolates from blood were E.coli （16.6%）, coagulase negative Stapyhlococcus （16.4%）, P.aeruginosa （11.6%）, K. pneumoniae （8.3%）, and S.aureu （7.6%）. Less than 30% of Gram-negative isolates from blood were resistant to meraopenem, Imipenem, Cefoperazone/Sulbactam, Amikacin, Piperacillin/Tazobactam, Ceftazidime, and Aztreonam. All Gram-positive isolates from blood were sensitive to Vancomycin and Teicoplanin. Conclusion For the rational use of antimicrobial agents, it is important to evaluate the drug resistance of bacterial and fungal isolates from patients with infection of the urinary system.