摘要
目的了解南平市第一医院成人尿路感染病原菌的分布和耐药性，为经验治疗提供依据。方法回顾性分析2009年1月-2011年12月医院门急诊与住院疑为尿路感染患者清洁中段尿培养及药敏试验结果，所有菌株采用VITEK-32细菌鉴定系统，药敏试验采用配套的革兰阴性菌GNS-142药敏卡，革兰阳性菌采用GPS-110药敏卡，根据2010年美国临床实验室标准化研究所标准操作和判断结果，数据用SPSSl3．0软件进行统计分析。结果共分离886株病原菌，其中366株分离自门急诊患者，520株分离自住院患者；门急诊和住院尿路感染患者病原菌以大肠埃希菌为主，分别占70．2％和45．0％、肠球菌属分别占8．2％和21．7％和克雷伯菌属分别占10．1％和8．7％；住院患者中分离病原菌的耐药性明显高于门急诊患者；大肠埃希菌对碳青霉烯类抗菌药物呈高度敏感占98．3％～99．6％，哌拉西林／他唑巴坦、头孢哌酮／舒巴坦、头孢吡肟、阿米卡星亦具有良好抗菌活性，但对广谱青霉素、一二代头孢菌素及环丙沙星耐药率较高；肠球菌属对万古霉素仍均呈高度敏感。结论大肠埃希菌是成人门急诊和住院尿路感染的最常见病原菌，住院患者病原菌耐药性较为严重；及时总结病原菌分布及其耐药性，对指导临床用药有重要意义。
OBJECTIVE To understand the distribution and drug resistance of pathogens causing urinary tract infections in adults of Nanping First Hospital so as to provide basis for empirical treatment. METHODS The patients with suspected urinary tract infections, who were hospitalized the emergency department from Jan 2009 to Dec 2011, were enrolled in the study. then the result of clean midstream urine culture and the drug susceptibility testing were retrospectively analyzed, all the strains were identified by using VITEK-32 bacterial identification system. the drug susceptibility testing was performed with the use of matched GNS-142 card for gram-negative bacteria and GPS-110 card for gram-positive bacteria. the results were determined according to the standards of Clinical Laboratory Standards Institute. and the statistical analysis was conducted by means of SPSS13. 0 software. RESULTS A total of 886 strains of pathogens have been isolated. among which 366 strains were isolated from the patients of emergency department. 520 strains from the hospitalized patients; the Escherichia coli was the predominant species of pathogen causing the urinary tract infection in the patients of emergency department （70.2%） and the hospitalized patients （45.0%）; the Enterococci accounted for 8.2% and 21. 7%. respectively; the Klebsiella accounted for 10. 1 % and 8. 7 % , respectively. The drug resistance rates of the pathogens isolated from the hospitalized patients were significantly higher than those of the pathogens isolated from the patients of emergency department; the drug susceptibility rate of the E. coli to carbapenems varied between 98. 3% and 99.6% I piperacillin-tazobactam, cefperazone-sulbactam , cefpime , and amikacin showed good anti-bacterial activity. however, the drug resistance rates to the broad spectrum penicillin, the first and second cephalosporins , and ciprofloxacin were high; the Enterococci remained highly susceptible to vancomycin. CONCLUSION The E. coli is the most common species of pathogen causing the urinary tract infection in the adults of emergency department or the hospitalized adults; the pathogens isolated from the hospitalized patients are highly resistant to antibiotics; it is of great significance to the clinical use of antibiotics to understand the distribution and drug resistance of the pathogens in a timely manner.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第5期1107-1109,共3页
Chinese Journal of Nosocomiology
基金
南平市医疗科技成果转化基金项目(N2012Z22C9J)
关键词
尿路感染
病原菌
耐药性
Urinary tract infection
Pathogen
Drug resistance
