泌尿系统感染主要病原菌分布及耐药性分析

目的 了解南京医科大学第一附属医院泌尿系统感染的主要病原菌分布及耐药情况.方法 收集2011年1月1日-12月31日南京医科大学第一附属医院泌尿系统感染患者的中段尿培养阳性菌株,采用api系统鉴定菌种,并用纸片扩散法进行药敏试验.结果 分离的1129株菌株中,革兰阴性菌667株,占59.1％；革兰阳性菌266株,占23.5％；假丝酵母菌属196株,占17.4％.革兰阴性菌中,大肠埃希菌、肺炎克雷伯菌及奇异变形杆菌对碳青霉烯类抗生素高度敏感；鲍曼不动杆菌与铜绿假单胞菌对头孢类及青霉素酶抑制剂等大部分抗菌药物的耐药率都在50％以上.革兰阳性球菌中粪肠球菌和鸟肠球菌对万古霉素和替考拉宁完全敏感,对利奈唑胺耐药率较低(＜10％).假丝酵母菌中的白假丝酵母菌和光滑假丝酵母菌主要对伏立康唑及氟康唑耐药率较高,为47.2％～60.0％,对两性霉素和制霉菌素全部敏感.结论 南京医科大学第一附属医院泌尿系统感染以革兰阴性菌为主,耐药形势严峻. abstract： objective to investigate the distribution and drug resistance of major pathogens for urinary tract infections in the first affiliated hospital of nanjing medical university.methods strains from midstream urine culture of patients with urinary tract infections were collected during january 1 and december 31,2011.all strains were identified by api system,and disk diffusion method was used for drug sensitivity test.results totally 1129 strains were isolated,in which 667 (59.1％ ) were gram-negative strains,266 (23.5％) were gram-positive strains,and 196 (17.4) were candida.among gram-negative strains,escherichia coli,klebsiella pneumoniae and proteus mirabilis were highly sensitive to carbapenem antibiotics; while acinetobacter baumannii and pseudomonas aeruginosa were highly resistant to most antibiotics including cephalosporins and penicillinase inhibitor,and the resistance rates were over 50％.among gram-positive strains,the major strains enterococcus avium and enterococcusfaecalis were completely sensitive to vancomycin and teicoplanin,and highly sensitive to linezolid (resistance rate below 10％ ).candida albicans and candida glabrata were highly resistant to voriconazole and fluconazole (with the resistance rates of 47.2％ - 60.0％ ), but were completely sensitive to amphotericin and nystatin.conclusion gram-negative strains account for most urinary tract infections in the first affiliated hospital of nanjing medical university with high drug resistance rates.

distribution and drug resistance of major pathogens for urinary tract infections