摘要
目的对近3年来尿路感染的菌谱及细菌耐药性进行调查分析，指导临床合理用药。方法收集从我院尿路感染患者尿液标本中分离的828株病原菌进行细菌鉴定及药敏试验（Kirby-Bauer法），并对革兰阴性杆菌进行超广谱8内酰胺酶（ESBLs）的检测。结果近3年尿路感染以革兰阴性杆菌为主，占68．24％，列前3位的是大肠埃希菌（56．64％），粪肠球菌（10．1）2％）、真菌（8．56％）。2004年至2006年超广谱8内酰胺酶大肠埃希氏菌比例呈上升趋势（分别占7．59％、23．2％、22．04％）。产酶大肠埃希菌对亚胺培南的耐药率是1．4％，对呋喃妥因的耐药率是23．21％，对头孢类耐药率59．38％～97．26％，对复方新诺明耐药率是95．31％。非产酶大肠埃希菌对亚胺培南的耐药率是0．3％，对呋喃妥因的耐药率是18．14％，对头孢类耐药率从8．87％～31．1）6％不等，对复方新诺明耐药率是72．62％。细菌对各种抗生素有不同程度的耐药性，表现为多重耐药。结论革兰阴性杆菌为尿路感染的主要病原菌，且产超广谱β内酰胺酶的大肠埃希菌呈上升趋势，定期监测尿路感染细菌谱及耐药性变化对于指导临床合理应用抗生素具有十分重要的意义。
Objective To investigate the bacteria spectrum variation and antibiotic resistance in urinary tract infection in recent years for guidance of appropriate selection of antibiotics. Method A total of 828 strains of pathogens from urinary samples of patients with urinary tract infection in our hospital were identified, and antibiotics sensitive test were performed. Antibiotic sensitive test adopted Kirby gauer method. ESBLs producing G- bacillus were also detected. Results Successive three years surveillance showed that G- bacillus was the most common pathogen（68.24%）,The three commonest pathogenes were escherichia Coli （56. 64% ）, Enterococcus faecalis （ 13. 64% ）, and fungus （8. 56 % ）. Escherichia Coli producing extended-spectrum β-1actamases increased by years（7. 59% in 2004,23. 0% in 2005, 22. 04% in 2006）. The resistant rate of Escherichia Coli producing extended-spectrumβ-lactamases to IMP and NIT was 0. 3% and 23. 21%. That to SMZco was 95.31%. To CAZ and CXM was more than 50%. The resistant rate of Escherichia Coli without extended-spectrumβ3-1actamase to IMP and NIT was 1.4% and 18. 14%. That to SMZco was 72. 62%. To CAZ and CXM was less than 30%. The bacteria showed different antibiotic resistance rate and multi-drug resistance. Conclusions G- bacillus was the major pathogens in urinary tract infection. Escherichia Coli producing extendedspectrum β-lactamases has a trend of increasing. It is very important to monitor the variation of bacteria spectrum and antibiotic resistance periodically, this makes the clinical use of antibiotic more reasonable.
出处
《临床肾脏病杂志》
2008年第2期63-66,共4页
Journal Of Clinical Nephrology
关键词
感染
尿路
病原菌
耐药性
Urinary tract infection
Pathogen
Antibiotic-resistance
