2009-2015年泌尿系感染病原菌种类构成及耐药性变迁

发布时间：2018-03-07 01:00

本文选题：泌尿系感染　切入点：耐药性　出处：《中华医院感染学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的了解泌尿系感染常见病原菌分布及耐药性,为临床抗菌药物使用及医院感染控制提供可靠依据。方法收集医院2009年1月-2015年12月分离的泌尿系感染病原菌4296株,采用Microscan Walkway 40分析系统和VITEK-2compact全自动药敏鉴定分析仪对菌株进行鉴定及药敏试验,并对结果进行分析。结果 4296株病原菌中,革兰阴性菌2476株占57.64%,革兰阳性菌1169株占27.21%,真菌651株占15.15%;分离率占前五位的分别为大肠埃希菌1098株(25.56%)、屎肠球菌570株(13.27%)、肺炎克雷伯菌380株(8.85%)、铜绿假单胞菌349株(8.12%),粪肠球菌300株(6.98%);碳青霉烯类对大肠埃希菌保持了较好的抗菌活性,但对铜绿假单胞菌、肺炎克雷伯菌出现了较高的耐药性,其耐药率分别为2.0%、41.2%、39.47%;屎肠球菌对各种抗菌药物的耐药率明显高于粪肠球菌,耐万古霉素的屎肠球菌和粪肠球菌检出率分别为38.9%、3.3%。结论医院泌尿系感染病原菌以革兰阴性菌为主,细菌耐药性监测能够对临床合理使用抗菌药物提供依据。
[Abstract]:Objective to investigate the distribution and drug resistance of common pathogens in urinary tract infection, and to provide reliable basis for clinical use of antibiotics and control of nosocomial infection. Methods 4296 strains of pathogenic bacteria of urinary tract infection were collected from January 2009 to December 2015 in hospital. Microscan Walkway 40 analysis system and VITEK-2compact automatic drug sensitivity analyzer were used to identify the strains and drug sensitivity test, and the results were analyzed. 2476 Gram-negative bacteria accounted for 57.64, 1169 Gram-positive bacteria accounted for 27.21 and 651 fungi accounted for 15.15.The first five isolates were Escherichia coli 1098, Enterococcus faecium 570, Klebsiella pneumoniae 380, Pseudomonas aeruginosa 8.12B. The antimicrobial activity of carbapenems against Escherichia coli was better. But the resistance of Klebsiella pneumoniae to Pseudomonas aeruginosa was higher than that of Enterococcus faecium, and the drug resistance rate of Klebsiella pneumoniae was 2.0 / 41.2 / 39.47.The resistance rate of Enterococcus faecium to various antimicrobial agents was significantly higher than that of Enterococcus faecalis. The detectable rates of vancomycin resistant Enterococcus faecium and Enterococcus faecalis were 38.9 and 3.30.Conclusion Gram-negative bacteria are the main pathogens of nosocomial urinary tract infection, and bacterial resistance monitoring can provide evidence for rational use of antimicrobial agents in clinic.
【作者单位】：北京大学第九临床医学院首都医科大学附属北京世纪坛医院临床检验中心尿液细胞分子诊断北京市重点实验室;
【基金】：北京市医管局首届登峰人才计划基金资助项目(DFL20150701)
【分类号】：R446.5;R691.3

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