尿路感染相关病原菌的分布及耐药性分析

发布时间：2018-05-17 21:07

本文选题：尿路感染 + 耐药性　；参考：《中国微生态学杂志》2017年03期

【摘要】：目的调查尿路感染病原菌的分布和耐药特点,为临床的抗感染治疗提供依据。方法收集2013年至2015年荆州市中心医院门诊和住院患者中,尿路感染患者送检的尿培养和血培养标本中检出的病原菌,采用Vitek2 Compact全自动微生物检测仪进行细菌鉴定,采用纸片扩散法和仪器法分别对革兰阴性杆菌和革兰阳性球菌进行药敏试验,药敏结果的判断依照CLSI M100-S24标准。数据分析采用WHONET5.6和SPSS 19.0软件,统计分析采用x~2检验。结果从尿路感染患者送检的标本中共检出各类非重复病原菌2 306株,其中门诊患者中检出19种100株,住院患者检出56种2 206株。导致尿路感染最多的两种病原菌为大肠埃希菌和粪肠球菌,分别检出1 241株和232株。导致尿脓毒血症最多的两种病原菌为大肠埃希菌和肺炎克雷伯菌,分别检出36株和10株。大肠埃希菌产ESBL.s率达67.9%,其对多种抗菌药物的耐药性均高于60.0%。粪肠球菌对大多数抗菌药物的耐药性均高于50.0%,仅对呋喃妥因和高浓度链霉素的耐药性较低,分别为12.0%和38.7%;未检出对万古霉素、利奈唑胺和替加环素耐药的粪肠球菌。结论导致尿路感染的病原菌种类繁多,大肠埃希菌和粪肠球菌是主要病原菌,其耐药情况严重;为保证治疗的有效性,临床医生应注重相关病原学和药敏检查结果。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in urinary tract infection. Methods from 2013 to 2015, the pathogenic bacteria were collected from urine culture and blood culture samples from outpatients and inpatients of Jingzhou Central Hospital. The bacteria were identified by Vitek2 Compact automatic microbiological detector. The susceptibility tests of Gram-negative bacilli and Gram-positive cocci were carried out by disk diffusion method and instrumental method, respectively. The results of drug sensitivity were judged according to CLSI M100-S24 standard. WHONET5.6 and SPSS 19.0 were used to analyze the data, and xan2 test was used for statistical analysis. Results A total of 2 306 strains of non-repetitive pathogens were detected from the specimens of urinary tract infection patients, including 19 species and 100 strains in outpatients, and 56 species and 2 206 strains in inpatients. Escherichia coli and Enterococcus faecalis were the two most common pathogens causing urinary tract infection, and 1 241 and 232 strains of Enterococcus faecalis were detected respectively. Escherichia coli and Klebsiella pneumoniae were the two most common pathogens causing urinary sepsis, 36 and 10 strains, respectively. The ESBL.s production rate of Escherichia coli was 67.9%, and its resistance to various antibiotics was higher than that of 60.0%. The drug resistance of Enterococcus faecalis to most antimicrobial agents was higher than that to most antibiotics, but the resistance to furantoin and high concentration streptomycin was lower (12.0% and 38.7%, respectively), and no vancomycin, linazolamide and tegacycline resistant Enterococcus faecalis was detected. Conclusion there are many kinds of pathogens causing urinary tract infection, Escherichia coli and Enterococcus faecalis are the main pathogens, their drug resistance is serious, in order to ensure the effectiveness of treatment, clinicians should pay attention to the results of related etiology and drug sensitivity examination.
【作者单位】：荆州市中心医院检验医学部;
【分类号】：R446.5;R691.3

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