钮博, 刘群, 李梅, 李峰, 陈黎忠, 王敏. 尿路感染分离菌1126株耐药性监测[J]. 蚌埠医学院学报, 2010, 35(8): 820-822.
    引用本文: 钮博, 刘群, 李梅, 李峰, 陈黎忠, 王敏. 尿路感染分离菌1126株耐药性监测[J]. 蚌埠医学院学报, 2010, 35(8): 820-822.
    NIU Bo, LIU Qun, LI Mei, LI Feng, CHEN Li-zhong, WANG Min. Observation of bacteria drug resistance in urinary tract infection[J]. Journal of Bengbu Medical College, 2010, 35(8): 820-822.
    Citation: NIU Bo, LIU Qun, LI Mei, LI Feng, CHEN Li-zhong, WANG Min. Observation of bacteria drug resistance in urinary tract infection[J]. Journal of Bengbu Medical College, 2010, 35(8): 820-822.

    尿路感染分离菌1126株耐药性监测

    Observation of bacteria drug resistance in urinary tract infection

    • 摘要: 目的:监测尿路感染患者尿液中分离的病原菌组成及耐药状况。方法:对1126株尿培养分离菌进行鉴定和耐药性分析,特殊耐药株细菌的检测均采用K-B法,并按照CLSI2006年版标准判断敏感率、中介率及耐药率。结果:1126株尿路感染分离菌中大肠埃希菌512株(45.5%),凝固酶阴性葡萄球菌属208株(18.5%),肠球菌属112株(9.9%),白色念珠菌61株(5.4%),变形杆菌55株(4.9%),肺炎克雷伯菌52株(4.6%)以及阴沟肠杆菌、铜绿假单胞菌(棒状杆菌4株、鲍曼不动杆菌等)。其中产超广谱β-内酰胺酶细菌检出率大肠埃希菌为48.0%,肺炎克雷伯菌38.6%,铜绿假单胞菌9.5%,耐甲氧西林凝固酶阴性葡萄球菌78.5%,耐万古霉素肠球菌1.8%,高耐庆大霉素的肠球菌80.4%;仅在大肠埃希菌检出1.4%头孢菌素酶株。碳青霉烯类仍是对G-杆菌(除嗜麦芽窄食单胞菌与黄杆菌)抗菌作用最强的一类抗生素,头孢哌酮/舒巴坦、哌拉西林/他巴唑坦、头孢吡肟等对G-菌亦有很好的抗菌活性;G+菌耐药率普遍较高,仅对万古霉素保持较好的敏感。结论:大肠埃希菌和凝固酶阴性葡萄球菌是尿路感染的主要病原菌。各种病原菌耐药率呈上升趋势,碳青霉烯类和万古霉素分别对G-杆菌和G+球菌抗菌最好、最强的一类抗生素,值得临床关注。

       

      Abstract: Objective: To monitor the composition and drug resistance of the pathogenic bacteria isolated from the urine of patients with urinary tract infections.Methods: One thousand one hundred and twenty-six drug-resistant bacteria isolated from urine were identified and analyzed,and the special drug-resistant strains were detected by K-B method.The sensitivity rate,intermediate rate and drug resistance rate were determined in accordance with CLSI 2006 standard.Results: Of the 1 126 strains isolated from patients with urinary tract infection,E.coli-based strains accounted for 45.5% (512/1 126),coagulase-negative Staphylococci 18.5% (208/1 126),Enterococcus 9.9% (112/1 126),Candida albicans 5.4% (61/1 126),Mycetozoan 4.9% (55/1 126),Klebsiella pneumoniae 4.6% (52/1 126),and the others were Enterobacter cloacae and Pseudomonas aeruginosa (Corynebacterium 4,such as Acinetobacter baumannii).The detection rate of ESBLs was 48.0% in E.coli,38.6% in Klebsiella pneumoniae,9.5% in Pseudomonas aeruginosa,78.5% in methicillin-resistant staphylococcus aureus,1.8% of vancomycin resistant enterococcal and 80.4% of high level aminoglikozyde resistance.Only 1.4% of Ampc was detected in E.coli strains.Carbapenems was still the most effective antibiotics for gram-negative bacteria (except maltophilia S.m and Flavobacterium).Cefoperazone/sulbactam,piperacillin/tazobactam and cefepime also presented good antibacterial activity.The resistance rate of Gram-positive bacteria was relatively high,only maintaining good sensitivity to vancomycin.Conclusions: Enterobacteriaceae and coagulase-negative staphylococci are the main pathogens for urinary tract infections.The resistant rate of a variety of pathogens tends to rise.Carbon penicillins and vancomycin are the best and strongest antibiotics for gram-negative bacilli and gram-positive cocci respectively,which is worth clinical attention.

       

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