泌尿系感染病原菌分布及耐药性分析

目的调查泌尿系统感染患者病原菌分布及常用抗生素耐药情况,以指导临床合理用药.方法用无菌方法收集患者尿液标本,采用Vitek-AMS鉴定病原菌和CLSI/NCCLS推荐的纸片扩散法进行药敏试验.结果从1882例患者的尿液标本中分离出1917株病原菌,大肠埃希菌、假丝酵母菌、肠球菌及表皮葡萄球菌分列前4位（32.2%、16.3%、10.8%和8.3%）.产超广谱β-内酰胺酶菌株（ESBLs）、耐甲氧西林表皮葡萄球菌（MRSE）、耐万古霉素肠球菌（VRE）和高水平庆大霉素耐药肠球菌（HLGR）检出率分别为30.5%、74.4%、0.78%和72.5%.MRSE和非MRSE对环丙沙星、复方新诺明、庆大霉素、红霉素及克林霉素的耐药率分别为72.3%和24.4%、63.0%和48.8%、37.8%和0、82.4%和68.3%、56.3%和12.2%.HIGR和非HIGR对环丙沙星、青霉素、氨苄西林和呋喃妥因的耐药率分别为86.7%和66.1%、66.0%和39.3%、74.0%和45.6%、19.2%和10.2%.结论大肠埃希菌为泌尿系感染的主要病原菌,假丝酵母菌分离率显著上升;特殊耐药菌株对常用抗菌药物的耐药率明显高于相应的普通菌株.

Study of the distribution and drug resistance of the pathogens isolated from patients with urinary infection

Objective: To investigate the distribution and drug resistance of the pathogens isolated from patients with urinary infection,and to guide clinician touse antibiotics reasonably.Methods: Pathogens were identified by Vitek-AMS and antimicrobial susceptibility test was detected by disk-diffusion method recommended by CLSI/NCCLS.Results: A total of 1917 pathogens were isolated from urine samples of 1882 patients.Among these pathogens,Escherichia coli was the most common(32.3%),followed by Candida spp(16.3%),Enterococcus(10.8%) and Staphylococcusepidermis(8.3%).ESBLs-produced bacteria,MRSE,VRE and HIGR strains was detected with 30.5%,74.4%,0.78% and 72.5% respectively,and their resistant rates to commonantibiotics were much higher than corresponding normal strains.Drug resistant rates of Candida spp to azole antifungal agents were between 9.9% and 13.7%.Conclusions: Escherichia coil is still the major urinary pathogens,the resistant ratesto common antibiotics are much higher than that of corresponding normal strains.