妇产科患者尿路感染的菌群分布及耐药性分析

发布时间：2018-10-26 15:55

【摘要】：目的探讨妇产科患者尿路感染的菌群分布和耐药特点,以指导医师合理选择抗菌药物。方法收集2014年1月-2015年12月妇产科临床住院患者尿培养分离的细菌,采用法国生物梅里埃公司VITEK-2Compact全自动细菌鉴定及药敏分析仪对菌株进行鉴定和药物敏感性试验。结果共收集尿培养阳性菌444株,来自409例尿路感染患者,444株病原菌中革兰阴性菌374株占84.2%,革兰阳性菌58株占13.1%,真菌12株占2.7%,排前3位病原菌依次为大肠埃希菌、肺炎克雷伯菌和粪肠球菌,分别占61.7%、10.8%和7.4%;大肠埃希菌和克雷伯菌属的ESBLs检出率较高,分别为74.5%和64.7%;除对碳青霉烯类、头孢替坦、哌拉西林/他唑巴坦、呋喃妥因、阿米卡星等药物耐药率较低外,对其他抗菌药物耐药较严重;粪肠球菌对青霉素G、替考拉宁、氨苄西林、利奈唑胺、万古霉素、替加环素、呋喃妥因等敏感,耐药率均9.0%;凝固酶阴性葡萄球菌对甲氧苄嘧啶、阿米卡星、利福平、替考拉宁、利奈唑胺、万古霉素、替加环素、呋喃妥因等耐药率均为0。结论大肠埃希菌和肺炎克雷伯菌是妇产科医院尿路感染的主要病原菌,产ESBLs比率高,耐药率较严重,应加强抗菌药物管理,合理使用抗菌药物。
[Abstract]:Objective to investigate the distribution and drug resistance of urinary tract infection in patients with gynecology and obstetrics. Methods from January 2014 to December 2015, bacteria isolated from urine of clinical inpatients in obstetrics and gynecology department were collected. The strains were identified by VITEK-2Compact automatic bacteria identification and drug sensitivity test. Results A total of 444 strains of positive bacteria were collected from 409 patients with urinary tract infection. Of the 444 strains, 374 were Gram-negative bacteria, 58 Gram-positive bacteria accounted for 13.1 and 12 fungi accounted for 2.7%. The top three pathogens were Escherichia coli, Klebsiella pneumoniae and Enterococcus faecalis, accounting for 10.8% and 7.4%, respectively. The detection rate of ESBLs in Escherichia coli and Klebsiella was 74.5% and 64.7%, respectively. In addition to carbapenem, ceftitan, piperacillin / tazobactam, furantoin, amikacin and other drug resistance rate is lower, and other antimicrobial drug resistance is more serious; Enterococcus faecalis was sensitive to penicillin G, teicoplanin, ampicillin, linazolamine, vancomycin, tegacyclin, furantoin, etc. The resistance rates of coagulase-negative staphylococci to trimethoprim, amikacin, rifampicin, teicoplanin, linazolamine, vancomycin, tegacyclin and furantoin were all 0. Conclusion Escherichia coli and Klebsiella pneumoniae are the main pathogens of urinary tract infection in gynecology and obstetrics department. The rate of ESBLs production is high and the rate of drug resistance is serious. The management of antimicrobial agents should be strengthened and antibiotics should be used rationally.
【作者单位】：复旦大学附属妇产科医院院感科;复旦大学附属妇产科医院检验科;
【分类号】：R691.3

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