摘要
目的探讨医院2009-2011年尿路感染患者病原菌分布及对抗菌药物的耐药变化,为临床合理应用抗菌药物提供依据。方法采用VITEK-2全自动微生物分析系统对病原菌进行鉴定和药敏试验,结果判定按照CLSI 2008年标准,用WHONET5.6软件对结果进行分析。结果 2009-2011年尿路培养出病原菌4976株,其中革兰阳性球菌1325株占26.63%、革兰阴性杆菌2861株占57.49%、真菌790株占15.88%,其中排名前5位病原菌依次为大肠埃希菌、肠球菌属、白色假丝酵母菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌,分别占31.17%、13.77%、8.98%、7.94%、7.58%;革兰阳性球菌对常用抗菌药物耐药率普遍较高,但对利奈唑胺、万古霉素仍保持敏感,未发现对利奈唑胺的耐药株;革兰阴性杆菌对常用抗菌药物均产生了一定的耐药性,在非发酵菌中,鲍氏不动杆菌和铜绿假单胞菌对亚胺培南的耐药率54.5%和36.3%;产ESBLs大肠埃希菌、肺炎克雷伯菌和奇异变形菌检出率分别为48.3%、45.1%和42.3%,并有逐年上升的趋势。结论及时准确的分析泌尿系感染的病原菌分布及耐药性,对于控制耐药菌株传播,指导临床合理选择抗菌药物具有重要的意义。
OBJECTIVE To investigate the distribution and drug resistance of the pathogenic bacteria causing urinary tract infections during 2009 -- 2011 so as to provide evidence for reasonable clinical use of antibiotics. METHODS VITEK-2 system was used to identify the pathogens, the drug susceptibility testing was performed, then the results were assessed by CLSI 2008 standards, and statistical analysis was conducted with the use of WHONETS. 6 software. RESULTS A total of 4976 clinical isolates of pathogens were isolated from urine culture, including 1325 （26.63%） strains of gram-positive cocci, 2861 （57.49%） strains of gram-negative bacilli, and 790 （18.88%） strains of fungi; Escherichia coli （31. 17%）, Enterococci （13.77%）, Candida albicans （8. 98%）, coagulase-negative Staphylococcus（7. 94%）, and Klebsiella pneurnonlae （7. 58%） ranked the top 5 species of pathogens isolated. The gram-positive cocci were highly resistant to the commonly used antibiotics but remained susceptibility to linezolid and vancomycin, and no strains resistant to linezolid were founds the gram-negative bacilli have produced certain drug resistance to the commonly used antibiotics, the drug resistance rates of such non-fermenting bacteria as acinetobacter baurnannii and Pseudomonas aeruginosa to imipenem were 54, 5% and 36.3%, respectively. The detection rate of the ESBLs-producing E. call was 48, 3%, the ESBLs-producing K. pneumoniae 45.1%, and the Proteusmirabilis （ 42.3%）, all of which showed an upward trend, CONCLUSION It is of great significance for the control of spread of drug resistant strains and for the reasonable use of antibiotics to accurately analyze the distribution and drug resistance of the pathogens causing urinary tract infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第22期5594-5596,共3页
Chinese Journal of Nosocomiology
基金
天津市卫生局基金项目(2011KY08)
关键词
尿路感染
病原菌
耐药性
Urinary tract infection, Pathogenic bacteria~ Drug resistance
