【摘要】 目的监测我国泌尿系统感染(尿感)住院患者细菌分布变化及耐药状况。方法以2000～2001年中国细菌耐药监测研究方案收集的菌株及采用平皿二倍稀释法测定的临床分离菌对不同类抗菌药物的最低抑菌浓度(MIC)为材料,比较尿感分离菌株和监测研究收集的全部菌株的耐药率。以50%和90%的细菌被抑制的最低药物浓度(MIC50、MIC90)表示抗菌药物的抗菌活性,并根据美国临床实验标准委员会(NCCLS2001)指定的指导原则,判定细菌对所测药物的耐药率和敏感率。结果全国九大城市13家医院的34个病房收集尿感细菌501株,其中社区感染与院内感染菌株之比为23.5∶1。致病菌所占比例为:革兰阴性杆菌317株,占63.3%,包括:大肠埃希菌35.9%,克雷伯杆菌属9.8%,铜绿假单孢菌5.2%,变形杆菌4.2%,阴沟肠杆菌2.0%;革兰阳性球菌184株,占36.7%,包括:肠球菌属13.6%,金黄色葡萄球菌8.0%,凝固酶阴性葡萄球菌13.2%、链球菌属2.0%。此外,念球菌9株。克雷伯杆菌属、阴沟肠杆菌、枸橼酸菌属、甲氧西林敏感金黄色葡萄球菌(MSSA)对喹诺酮类等抗生素的耐药率与总体研究结果比较增高(P≤0.05或P≤0.001)。结论泌尿系统感染的主要致病菌仍为革兰阴性杆菌,但肠球菌的比例明显升高。革兰阴性杆菌对某些抗生素耐药尤其对喹诺酮类药物耐药较总体结果严重。更多还原

【Abstract】 Objective To determine the bacterial isolate rates and resistance rates in urinary tract infections (UTI) of hospitalized patients. Methods According to the previous protocol, from July 1,2000 to June 30,2001, pathogenic strains were collected for susceptibility test using international standard plate dilution method. According to the criteria of guidelines of NCCLS(2001), MIC50 and MIC90 were detected for antibacterial activity of antimicrobial agents.R%and S%were calculated to show the resistant and susceptible rates of bacteria to the compounds tested. And the resistant rates of bacteria isolated from UTI were compared with the whole research. Results 501 strains of bacteria from UTI patients were located in 34 study wards of 13 hospitals at different areas in China. The ratio of community acquired infections to hospital acquired infections was 23 5∶1. Gram negative bacilli made up 63 3%(317 strains) of isolates (E.coli 35 9%,Klebsiella spp 9 8%, Pseudomonas aeruginosa 5 2%, Proteus spp 4 2%, Ent. cloacae 2 0%). Gram positive cocci made up 36 7%(184 strains) of isolates(Enterococcus spp13 6%,S. aureus 8 0%, S.coagulase nagative 13 2%, Staphylococcus spp 2 0%) .Nine strains of candida were isolated. The resistant rate of Klebsiella spp, Ent. cloacae, Citrobacter spp and MSSA to quinolones were higher than the whole research isolated strains(P≤0 05 or P≤0 001). Conclusions Gram negative bacilli is the most predominant organism, and infection rate of Enterococcus spp increases obviously. The gram negative bacilli resistance of UTI to some antibiotics,especially to quinolones,are more serious than that of whole surveillance.更多还原