尿路感染常见病原菌分布及药敏分析

目的研究尿路感染的常见病原菌分布及耐药性,为临床合理应用抗菌药物提供依据。方法应用Walkaway 40型全自动细菌鉴定仪对815株尿路感染病原菌进行鉴定和药敏分析。结果 815株病原菌中,以革兰阴性杆菌为主,共630株(77.3%),革兰阳性球菌138株(16.9%),真菌47株(5.8%)。在所有分离菌中,大肠埃希菌检出率最高,为418株(51.3%),其余依次为粪肠球菌66株(8.1%),肺炎克雷伯菌65株(8.1%),奇异变形杆菌60株(7.4%)。药敏结果显示革兰阴性杆菌对美洛培南敏感性最高,耐药率低于12.0%,对氨苄西林耐药率高达69.6%～95.7%。革兰阳性球菌中,葡萄球菌对万古霉素均敏感,但对苯唑西林耐药率高达93.8%;粪肠球菌对6种抗菌药物的耐药率高达76.4%～92.8%。结论革兰阴性杆菌在尿路感染中仍占绝对优势;不同菌种对不同抗菌药物耐药率差别较大;合理使用抗菌药物对有效控制尿路感染和避免耐药菌株的产生尤为关键。

Distribution of common pathogenic bacteria in urinary tract infection and analysis of drug susceptibility

Objective To study the distribution of the common pathogenic bacteria in urinary tract infection and to analyze the drug susceptibility in order to offer scientific reference for the rational clinical use of antibacterial agents.Methods Using Walkaway 40 fully automatic bacteria identification apparatus to identify 815 bacteria in urinary tract infection and test their drug susceptibility,and then carry out statistic analysis.Results Among the 815 pathogenic bacteria,the major was Gram negative bacilli,totalling 630 （77.3%）; there were 138 Gram positive bacilli （16.9%）,47 epiphyte （5.8%）.Among all the bacteria,the detectable rate of Escherichia coli was the highest,totalling 418 （51.3%）; the next was Enterococcus faecalis,totalling 66（8.1%）; there were Klebsiella pneumoniae 65 （8.1%）,Balcillus proteus mirabilis 60（7.4%）.The result of drug susceptibility showed that the susceptibility of the Gram negative bacilli to Meropenem was the highest.Its drug resistance rate was lower than 12.0%.Its drug resistance rate to ampicillin was as high as 69.6%-95.7%.Among the Gram positive bacilli,the staphylococcus was sensitive to vancomycin,but it had a drug resistance rate as high as 93.8% to Oxacillin.The drug resistance rate of Enterococcus faecalis to the six antibiotics was as high as 76.4%～92.8%.Conclusion Gram negative bacilli still take the absolute advantage in urinary tract infection.Different bacteria have different drug resistance rates to different antibiotics.Using antibiotics is the key for effectively controlling urinary tract infection and avoiding the generation of drug-resistant strain.