泌尿系统感染患者病原菌的分布及其耐药性分析

doi:10.13481/j.1671-587x.20150331

吉林大学学报(医学版) ›› 2015, Vol. 41 ›› Issue (03): 593-598.doi: 10.13481/j.1671-587x.20150331

泌尿系统感染患者病原菌的分布及其耐药性分析

张鹏¹, 车丽赫¹, 郭志敏², 娄丽新¹, 鲍万国¹, 李玉香¹

1. 吉林大学第一医院感染症科, 吉林长春 130021;
2. 吉林大学第一医院检验科, 吉林长春 130021

收稿日期:2014-09-05 发布日期:2015-08-01
通讯作者: 李玉香,副教授,硕士研究生导师(Tel:0431-88782513,E-mail:yuxiangli2@yahoo.com.cn) E-mail:yuxiangli2@yahoo.com.cn
作者简介:张鹏(1981-),男,山东省青岛市人,主治医师,医学硕士,主要从事感染性疾病诊断和治疗方面的研究。
基金资助:
国家自然科学基金资助课题(30771912)

Analysis on distribution and drug resistance of pathogens in patients with urinary tract infections

ZHANG Peng¹, CHE Lihe¹, GUO Zhimin², LOU Lixin¹, BAO Wanguo¹, LI Yuxiang¹

1. Department of Infectious Disease, First Hospital, Jilin University, Changchun 130021, China;
2. Department of Laboratory, First Hospital, Jilin University, Changchun 130021, China

Received:2014-09-05 Published:2015-08-01

摘要/Abstract

摘要：

目的:探讨本院泌尿系统感染常见的病原菌的分布、病区分布和细菌对抗菌药物耐药的情况,为临床不同科室合理、及时选用有效抗菌药物提供参考依据。方法:收集本院各科室患者清洁中段尿尿培养阳性的252例标本,共分离出270株病原菌,分析这些病原菌菌种、药敏及耐药性情况,同时分析其病区分布情况。结果:270株泌尿系感染的菌株中以革兰阴性菌为主,共计202株(74.81%),尤以大肠埃希菌最为常见,共121株(44.81%),其次为肺炎克雷伯菌24株(8.89%)、铜绿假单胞菌10株(3.70%)、产酸克雷伯菌9株(3.33%);在革兰阳性菌中以屎肠球菌最为多见,共20株(7.41%),其次为草绿色链球菌12株(4.44%)、粪肠球菌10株(3.70%);细菌对各种抗菌药物有不同程度的耐药率,产超广谱β-内酰胺酶(ESBLs)的共28株,占所有杆菌的13.86%。产ESBLs的大肠杆菌对头孢噻肟、头孢呋辛、头孢曲松和哌拉西林的耐药率为100%,对亚胺培南和美罗培南的耐药率为0%。对美罗培南耐药的杆菌共有8株,占所有202株杆菌的3.96%。屎肠球菌对利奈唑胺和替考拉宁的敏感率为100%,对万古霉素的耐药率为5%。不同科室间病原菌有所不同,ICU科患者屎肠球菌感染排第1位,其次为大肠埃希菌;干部病房患者屎肠球菌和大肠埃希菌感染率相同,其他主要科室以大肠埃希菌比例最高。结论:泌尿系统感染的病原菌以杆菌为主,但球菌所致的尿感应引起重视。细菌对多种药物有一定耐药性,不同临床科室泌尿系统感染的优势致病菌有所不同,提示对不同患者应制定个性化治疗方案。

关键词: 泌尿系统感染, 病原菌, 抗生素, 耐药率

Abstract:

Objective To investigate the distribution of common pathogens in different departments and drug resistance of these pathogens in the patients with urinary tract infections in our hospital, and to provide reference basis for selecting reasonable, timely and personal treatment plan with effective antibiotic agents for the patients in different clinical departments. Methods 252 urine samples with positive culture from the hospitalized patients were collected and the sensitivity Results and bacterial resistance rates were obtained.The distribution of 270 strains isolated from 252 samples and the susceptibility Results were analyzed and the drug resistance of bacteria in different departments was compared. Results In 270 strains, the number of gram-negative bacteria was 202 (74.81%), Escherichia coli was the most common pathogen (121, 44.81%), followed by Klebsiella pneumoniae (24, 8.89%), Pseudomonas aeruginosa (10, 3.70%), Klebsiella oxytoca (9, 3.33%);In gram-positive bacteria, feces Enterococcus was the most common pathogen (20, 7.41%), followed by Viridans (12, 4.44%), Enterococcus faecalis (10, 3.70%);ESBLs-producing pathogens were 28 strains which accounted for 13.86% of all bacteria.The number of meropenem-resistant bacteria was 8 strains.All feces Enterococci were sensitive to linezolid and teicoplanin, but of which the resistance rate was 5.0% for vancomycin.The pathogens were different in different departments, such as the number of feces Enterococcus in ICU was the most, followed by Escherichia coli;in VIP ward, the infection rates of Enterococci and Escherichia coli in the patients were the same;in other major departments the Escherichia coli had the highest proportion of bacteria. Conclusion Bacilus is the main pathogenic bacterium in the patients with urinary tract infections, but the coccus should be paid attention.The pathogenic bacteria have resistance to many drugs, and the main pathogenic bacteria vary in different departments, so the personal treatment plan for different patients should be made.

Key words: urinary tract infections, pathogenic bacteria, antibiotics, drug resistance rate

中图分类号:

R691.3

张鹏, 车丽赫, 郭志敏, 娄丽新, 鲍万国, 李玉香. 泌尿系统感染患者病原菌的分布及其耐药性分析[J]. 吉林大学学报(医学版), 2015, 41(03): 593-598.

ZHANG Peng, CHE Lihe, GUO Zhimin, LOU Lixin, BAO Wanguo, LI Yuxiang. Analysis on distribution and drug resistance of pathogens in patients with urinary tract infections[J]. Journal of Jilin University Medicine Edition, 2015, 41(03): 593-598.

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泌尿系统感染患者病原菌的分布及其耐药性分析

Analysis on distribution and drug resistance of pathogens in patients with urinary tract infections

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