2003年～2009年湖北十堰地区尿培养病原菌分布及耐药性变迁

目的 探讨2003年～2009年近6年间湖北十堰地区泌尿系统感染病原菌的分布及耐药性的变迁情况,以指导临床合理使用抗生素.方法 应用回顾性分析方法,从十堰市太和医院2003～2009年间尿培养阳性患者中随机抽取1/3病例,对其病原菌分布和耐药性变迁进行统计分析.结果 378株病原菌中G-菌检出率大于G＋菌;G-菌检出率显著上升（P＜0.05）,大肠埃希菌仍为泌尿系统感染主要致病菌;G＋菌检出率下降（P＜0.05）.大肠埃希菌对碳青霉烯类抗生素敏感,对头孢类抗菌药物耐药率明显增加（P＜0.05）;G＋对万古霉素和替考拉宁最为敏感,表皮葡萄球菌对氯霉素耐药率显著增加（P＜0.05）,肠球菌属对头孢西丁耐药性明显增加（P＜0.05）.结论 2003～2009年间泌尿系统感染病原菌分布发生变迁,多种常用药物耐药性明显增加,临床医生需结合本地区菌群分布和耐药情况,以细菌学和药物敏感试验结果作为依据合理选用抗菌药物.

Variation and drug resistance of pathogens in urinary system infection in the Shiyan region of Hubei province

Objective To study the pathogenie distribution and drug-resistance of bacteria with urinary tract infection（UIT） in recent six years from 2003 to 2009 in the Shiyan region of Hubei province, in order to direct rational use of antibiotics. Methods The drug-resistance and pathogens from one third of the total strains of patients who were randomly taked in positive urine culture from 2003 to 2009 in Taihe hospital were analyzed retrospectively. Results Amount of gram-negative bacilli is greater than gram-positive cocci among 378 strains, the amount of gram-negative bacilli of which the Eseherichia coli was still the mainly pathogen went up significantly （ P 〈 0.05 ） ; decrease of gram-positive cocci is significant （ P 〈 0.05 ）. The eseherichia coli were sensitive to carbapenem antibiotics, the antimierobial resistance for cephalosprins was significantly increased（ P 〈 0.05 ） ;the gram-positive cocci were sensitive to vaneomycin and teicoplanin, staphylococcus epidermidis resistant to ehloramphenicol was significantly increased （P 〈 0.05 ） and resistance of Enterococcus to Cefoxitin increased significantly （ P 〈 0.05 ）. Conclusions Fom 2003 to 2009 the urinary tract infection pathogenic changes, the rate of drug-resistance increased among many common drugs, cliniciansneed to combine medication distribution and drug-resistant bacteria, take teriology and drug sensitivity test results as the basis for a reasonable antimierobial selection.