【摘要】 目的了解尿路感染病原菌分布及对常用抗菌药物的耐药性,以指导临床合理用药。方法分析2006年1月-2007年12月尿培养分离出的病原菌检出情况及耐药性,并对革兰阴性杆菌进行ESBLs检测。结果共有尿标本2773份,检出722株病原菌,检出率为26.0%,其中革兰阴性菌占69.4%,革兰阳性菌占16.3%,真菌占14.3%;尿路感染中检出的前5位病原菌依次是:大肠埃希菌(47.9%)、屎肠球菌(7.9%)、奇异变形菌(3.9%)、粪肠球菌(4.0%)、铜绿假单胞菌(3.5%);革兰阴性杆菌对亚胺培南、美罗培南较为敏感,对多种抗菌药物耐药,但奇异变形菌对阿米卡星和部分头孢菌素较为敏感;革兰阳性球菌对苯唑西林、青霉素和复方新诺明等表现出较高耐药,对万古霉素、呋喃妥因敏感。结论尿路感染中大肠埃希菌是主要的病原菌,应及早进行细菌培养和药敏试验,为临床提供合理的用药依据。更多还原

【Abstract】 OBJECTIVE To investigate the bacterial distribution and antibiotic resistance of main pathogens from urinary tract infection (UTI) in our hospital for the guidance of rational use of antibiotics. METHODS The antibiotic resistance of clinical pathogen isolates from urinary tract infection by routine bacterium culture from Jan 2006 to Dec 2007 were studied retrospectively. The extended spectrum β-lactamases (ESBLs) were detected out to the Gram-negative bacilli. RESULTS There were 722 strains of pathogens in the whole 2773 urinary samples with the isolating rate 26.0%. Most of the Urinary tract infections of patients were caused by Gram-negative bacilli (69.4%),then by Gram-positive cocci (16.3%) and fungi (14.3%). The most common pathogens in urinary tract infection were Escherichia coli (47.9%),Enterococcus faecais (7.9%),E. faecium (4.0%),Proteus mirabilis (3.9%),and Pseudomonas aeruginosa (3.5%). The Gram-negative bacilli were found to be sensitive to imipenem and meropenem,but highly resistant to the most other antibiotics,while P. mirabilis was susceptive to amikacin and cephalosporins. The Gram-positive cocci were more sensitive to nitrofuvantoin and vancomycin,but highly resistant to penicillin,oxacillin and SMT. CONCLUSIONS E. coli is still the primary urinary pathogen among patients,and highly resistant to a lot of antibiotics,We should carry out cultivation,isolation,and antimicrobial susceptibility testing as soon as possible to guide reasonable clinical drug therapy.更多还原