泌尿系感染的病原菌分布及耐药性分析

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1、·350·ChinJNosocomiolVol.14No.32004·论　著·泌尿系感染的病原菌分布及耐药性分析12111赵建平,周艳萍,白晓红,李风娥,杨国香(1.内蒙古自治区医院,内蒙古呼和浩特010017;2.包头铝厂集团职工医院,内蒙古包头014046)摘要:目的　了解泌尿系感染患者的病原菌分布及耐药性,指导临床合理用药。方法　从尿标本中分离出670株(男性217株,女性453株)病原菌进行耐药性分析,特殊耐药株如MRS株、VRE株、HLAR株、产ESBLs细菌的检测及体外药敏试验均采用K2B法。结果　分离前5位的细菌依次为大肠埃希菌(占54%)

2、、凝固酶阴性葡萄球菌(6%)、肺炎克雷伯菌(5%)、铜绿假单胞菌(4%)、弗氏柠檬酸杆菌(4%);产ESBLs细菌的检出率为11.6%,MRSCON株为74.3%,VRE株为28.9%,HLAR株为70.3%;大肠埃希菌对阿米卡星、呋喃妥因和B2内酰胺类抗生素(青霉素类除外)敏感性较好(72%～97%),对喹诺酮类抗生素较差(16%～18%)。结论　大肠埃希菌为泌尿系感染的主要病原菌,占>50%;女性患者明显高于男性;过去常用于治疗泌尿系感染的喹诺酮类抗生素,耐药性较高;临床应结合药敏试验和特殊耐药株的报告结果,合理选择抗生素。关键词:病原菌;大肠埃希菌

3、;耐药性;医院感染中图分类号:R691.3文献标识码:A文章编号:100524529(2004)0320350203PathogensinUrinarySystem:TheirDestributionandResistanceAnalysisZHAOJian2ping,ZHOUYan2ping,BAIXiao2hong,LIFeng2e,YANGGuo2xiang(DepartmentofClinicalLaboratory,InnerMongoliaARHospital,Huhhot010017,China)Abstract:OBJECTIVEToin

4、vestigatethedistributionanddrugresistanceofthepathogensinthepatientswhosufferedfromtheurinaryinfection,thenhelptheclinictousedrugrationally.METHODSAtotalof670bacteriawereisolatedfromtheurineandgivenresistanceanalysis(men217strains,women453strains).Thetestandextracorporealantimicr

5、obialagentssusceptibilitytookK2BmethodwhichwasusedforspecialresistantstrainssuchasMRS,VRE,HLARandtheESBLs2producedbacteria.RESULTSThefirst5wereEscherichiacoli(54%),coagulasenegativestaphylococcus(6%),Klebsiellapneumoniae(5%),Pseudomonasaeruginosa(4%),andCitrobacterfreundii(4%).Th

6、erateoftestwasdifferent,ESBLs2producedbacteriawere11.6%,MRSCON74.3%,VRE28.9%,HLAR70.3%.E.coliwassensitivetoamikacin,nitrofurantoinandbeta2lac2tamantibiotics(exceptpenicillin)(72297%),butlesssensitivetoquinolonesantibiotics(16218%).CONCLU2SIONSMorethanhalfoftheurinarypathogensisE.

7、coli;womenaremoresignificantthanmen.Quinolonesan2tibioticswhichweusedbeforehavehighresistance,sotheclinicshouldconsidertheantimicrobialagentsuscepti2bilityandspecialresistantstraintestreportandchoicedrugrationally.Keywords:Pathogen;Escherichiacoli;Drugresistance;Hospitalinfection

8、　　随着抗生素的广泛使用,越来越多的细菌出现1材料与方法了耐药,进而增加了临床对