泌尿系感染病原菌临床调查及耐药性分析

目的了解鹤岗市人民医院2007年1月至2009年12月泌尿系病原菌菌株分布,分析抗菌药的敏感情况,为临床合理应用抗菌药提供实验室依据。方法 2007年1月至2009年12月该院泌尿系感染者2375例中段尿标本分离出776株病原菌进行鉴定和体外药物敏感试验,采用法国生物梅里埃公司ATB鉴定系统对菌株进行鉴定,采用纸片扩散法（即K-B法）进行抗菌药敏感性试验。结果在泌尿系感染大肠埃希菌和肠球菌的检出率分别为40.3%和19.7%;革兰阴性菌对亚胺培南敏感性较高,对氨苄西林、头孢唑林耐药率较高。革兰阳性菌对万古霉素全部敏感,对氨苄西林、青霉素耐药率较高。真菌检出率为16.1%,真菌对两性霉素、氟康唑敏感性高。结论泌尿系感染以大肠埃希菌和粪肠球菌为主,耐药呈上升趋势。临床医师应严格依照泌尿道感染致病菌的种类及药敏结果合理应用抗菌药物。

Distribution and drug resistance analysis of pathogens in urinary infection

Objective To investigate the pathogen distribution and drug sensitive rate of urinary system infection in The People＇s Hospital of Hegang City,and provide diagnostic evidence for clinic physicians. Method A total of 2 375 pathogen strains in urinary infection from inpatients and outpatients were cultured and identified by ATB and K-B method was performed for drug sensitivity test. Result Escherichia coli was one of the most common（40.3%） in urinary infection,followed by Enterococcus（19.7%）. The results of antibiotic susceptibility test in vitro showed that the susceptibility of Gram-negative bacteria to imipenem（IPM） was higher,so was their resistance to ampicillin（AMP） and cefazolin（KZ）; G-positive cocci were found sensitive to VA,while resistant to ampicillin（AMP） and pennicillin（P）.The detection rate of Fungus were 16.1% in the urine specimen. Conclusion Escherichia coli and E.faecalis are the main bacteria in urinary infection.And their drug resistance tends to rise. Rational use of antibiotics according to urine culture results and drug sensitivity test are the important way to reduce the spread of drug resistance.