广州医科大学学报

目的:探讨我院986株泌尿道感染病原菌的分布特征以及耐药性。方法:采用法国生物梅里埃公司生产的API系统和纸片扩散法对病原菌种进行鉴定和药物敏感试验,利用WHONET 5.3软件分析病原菌的分布特征以及耐药情况。结果:泌尿道感染致病菌仍以革兰氏阴性菌为主,大肠埃希菌为主要的致病菌(387株/39.25%),其次为真菌(139株/14.10%)和凝固酶阴性葡萄球菌(110株/11.16%)。共检测出192株超广谱β-内酰胺酶(ESBLs)阳性菌株,其中大肠埃希菌产ESBLs154株,占比39.79%,肺炎克雷伯菌产ESBLs38株,占比65.52%。药敏结果提示,大肠埃希菌和肺炎克雷伯菌菌对阿米卡星、亚胺培南等耐药率较低,对氨苄西林耐药率最高。凝固酶阴性葡萄球菌和肠球菌属对青霉素类、氨基糖苷类药物耐药性较高,但未发现利奈唑胺和万古霉素耐药菌株。结论:革兰氏阴性菌仍是泌尿系统感染的主要病原菌,以大肠埃希菌为主,对泌尿道感染患者进行病原菌的分布特征和耐药性检测有助于指导临床科学合理应用抗生素药物,最大限度降低耐药菌株产生,积极有效的控制患者感染病情,有助于降低患者住院费用和周期,促进患者的早日康复。

Objective: To investigate the distribution and drug resistance of 986 urinary tract infection pathogens in our hospital. Methods: The API system and the disk diffusion method produced by French Bio Merieux Company were used to identify the pathogenic bacteria and to test the drug sensitivity. The WHONET5.3 software was used to analyze the distribution characteristics and drug resistance of pathogens.Results: Gram-negative bacteria were the main pathogens of urinary tract infection,Escherichia coli( E. coli)were the main pathogens( 387 strains/39.25%),followed by fungi( 139 strains/14.10%) and coagulase-negative staphylococci( 110 strains/11. 16%). A total of 192 extended-spectrum β-lactamase( ESBLs) positive strains were detected,of which of ESBLs( 154 strains/39.79%) were produced by E. coli,and ESBLs( 38 strains/65.52%) were produced by Klebsiella pneumoniae. According to the findings of drug sensitivity test,E. coli and Klebsiella pneumoniae showed lower resistance rates to Amikacin and Imipenem,and the resistance rate to Ampicillin was the highest. Coagulase-negative staphylococci and Enterococcus species were highly resistant to Penicillins and Aminoglycosides,but no Linezolid and Vancomycin-resistant strains were found. Conclusion:Gram-negative bacteria are still the main pathogens of urinary tract infections,mainly E. coli. Determination of pathogenic bacteria distribution and drug resistance in patients with urinary tract infections is helpful for guiding the rational and scientific use of antibiotics in the clinical settings,minimizing the production of drug-resistant strains,actively and effectively controlling the infection of patients,reducing the hospitalization cost and length of stay,and promoting the early recovery of patients.