摘要
目的对解放军第九二五医院收治患者中段尿培养病原菌的分布情况及耐药性进行探讨,为临床合理选用抗生素(抗真菌药物)治疗泌尿系统感染提供参考依据。方法通过VITEK 2 Compact分析仪及配套的鉴定卡、药敏卡进行病原菌的鉴定及药敏试验(念珠菌药敏试验使用ATB FUNGUS 3药敏卡完成)。结果 1987例清洁中段尿标本共分离出病原菌600株,革兰阴性杆菌占65.5%、革兰阳性球菌占18.8%、念珠菌占15.7%。病原菌以大肠埃希菌、屎肠球菌、肺炎克雷伯菌、奇异变形杆菌及光滑念珠菌多见。大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌中产超广谱β-内酰胺酶(ESBLs)菌株分别占55.0%、40.0%、27.9%,凝固酶阴性葡萄球菌中耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)占75.0%。革兰阴性杆菌对氨苄西林、头孢唑林、复方磺胺甲噁唑等抗生素的耐药率均>50.0%,对哌拉西林/三唑巴坦、阿米卡星的耐药率较低,对亚胺培南的耐药率最低;革兰阳性球菌对青霉素、红霉素、克林霉素、四环素、复方磺胺甲噁唑等具有较高的耐药性,对万古霉素、替加环素、利奈唑胺高度敏感,屎肠球菌的耐药率高于粪肠球菌;不同念珠菌对抗真菌药物的耐药率有差异,白色念珠菌对抗真菌药物耐药率较低,光滑念珠菌、近平滑念珠菌的耐药率明显高于白色念珠菌。结论泌尿系统感染病原菌种类较多,革兰阴性杆菌是感染的主要病原菌,不同病原菌耐药率有差异,临床应积极进行清洁中段尿培养及药物敏感试验,根据药敏结果合理选择药物治疗。
Objective To investigate the distribution and drug resistance of pathogenic bacteria in the urine culture of a hospital, and to provide a reference for the rational selection of antibiotics(antifungal drugs) in the treatment of urinary system infection. Methods Pathogen identification and drug susceptibility test were carried out by VITEK 2 compact analyzer, supporting identification cards and drug susceptibility cards(the drug susceptibility test of candida FUNGUS was completed by ATB FUNGUS 3 drug susceptibility card). Results 600 pathogens were isolated from 1987 urine samples, in which Gram negative bacilli, Gram positive cocci and Candidiasis accounted for 65.5%, 18.8% and 15.7%, respectively. The pathogenic bacteria were mainly Escherichia coli, Enterococcus excreta, Klebsiella pneumoniae, Proteus mirabilis and Candida glabrata. Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis Extended-spectrum β-lactamases(ESBLs) strains in the middle class of chitosan were 55.0%, 40.0% and 27.9% respectively. The drug resistance rates of gram-negative bacillus to antibiotics such as ampicillin, cefazolin and compound sulfamethoxazole were all above 50.0%. The drug resistance rates of Piperacillin/tazobatan and amikacin were lower, and the drug resistance rates of Impenan were the lowest. Gram-positive coccus was highly resistant to Penicillin, erythromycin, clindamycin, tetracycline, compound sulfamethoxazole, etc. It is highly sensitive tovancomycin, tigacycline and linazolamide. The drug resistance of candida albicans against fungal drugs was different from that of candida albicans. The drug resistance of candida albicans against fungal drugs was lower than that of candida albicans. Conclusion There are many kinds of pathogenic bacteria of urinary system infection. Gramnegative bacillus is the main pathogenic bacteria of infection, and the drug resistance of different pathogenic bacteria is different. In clinical practice, clean middle segment urine culture and drug sensitivity test should be carried out actively, and drug treatment should be well chosen according to the results of drug sensitivity.
作者
郑瑶
赵德军
胡昭宇
曹雁
武静
王发丽
王怡雪
Zheng-Yao;Zhao De-jun;Hu Zhao-yu;Cao Yan;Wu Jing;Wang Fa-li;Wang Yi-xue(The 925^th hospital of PLA,Guiyang 550009;The first People's Hospital of Qingzhen City,Qingzhen 551400)
出处
《国外医药（抗生素分册）》
CAS
2019年第1期82-86,共5页
World Notes on Antibiotics
关键词
尿培养
病原菌
抗生素
耐药性
urine culture
pathogenic bacteria
antibiotics
drug resistance
作者简介
郑瑶,检验技师,主要从事微生物学检验及研究;通信作者:赵德军,主管技师,主要从事实验室诊断及研究。
