【摘要】 目的了解院内临床尿培养中常见病原菌的耐药性,为临床经验治疗泌尿道病原菌引起的感染提供依据。方法 2013年全院尿培养共分离1 173株病原菌,分离率居前二位的病原菌分别是445株大肠埃希菌和111株肺炎克雷伯菌,用WHONET 5.6对大肠埃希菌和肺炎克雷伯菌耐药性及分布进行分析。结果 445株大肠埃希菌对阿莫西林/克拉维酸、呋喃妥因、头孢西丁、阿米卡星、哌拉西林/他唑巴坦、厄他培南、美洛培南和亚胺培南的耐药率为0.2%~27.0%,对氨曲南、头孢吡肟和头孢他啶的耐药率分别47.0%(209/445)、43.6%(194/445)和33.9%(151/445),对左旋氧氟沙星、头孢噻肟和庆大霉素的耐药率均>50%,对头孢呋辛、磺胺甲噁唑/甲氨苄啶、头孢唑啉、环丙沙星、四环素和氨苄西林的耐药率为61.6%~89.7%。111株肺炎克雷伯菌对阿米卡星、哌拉西林/他唑巴坦、厄他培南、美洛培南和亚胺培南的耐药率为3.6%~16.2%,对头孢西丁、左旋氧氟沙星、头孢吡肟、头孢他啶、阿莫西林/克拉维酸、庆大霉素和氨曲南的耐药率为34.2%~48.6%,对头孢噻肟、磺胺甲噁唑/甲氨苄啶、四环素、环丙沙星和头孢呋辛的耐药率为58.5%~72.1%,对头孢唑啉、呋喃妥因和氨苄西林的耐药率为80.2%~100%。大肠埃希菌的标本来源主要是泌尿内科病房和泌尿内科门诊,其次是神经内科病房和内分泌病房。肺炎克雷伯菌的标本来源主要是泌尿内科病房,其次是神经内科病房、ICU病房和泌尿内科门诊。结论本院引起泌尿道感染的常见菌对临床常用的抗菌药物耐药率均存在一定的差异,标本主要分布在泌尿内科,临床应根据药敏结果选用抗菌药物。更多还原

【Abstract】 Objective To investigate the drug-resistance of common bacteria separated from urine cultures in clinical, and provide evidence for the clinicians to treat infections caused by urinary tract pathogens on the basis of experience. Methods In 2013, a total of 1 173 pathogenic bacteria were isolated from urine cultures. Escherichia coli and Klebsiella pneumoniae were on the top two of the isolation rates. Drug-resistance and distribution of 455 strains of Escherichia coli and 111 strains of Klebsiella pneumoniae were analyzed by WHONET 5.6 analytics software. Results Drug-resistance rates of 455 strains of Escherichia coli to amoxicillin/clavulanic acid, nitrofurantoin, cefoxitin, amikacin, piperacillin/tazobactam, ertapenem, imipenem and meropenem were 0.2%-27.0%, to aztreonam, ceftazidime and cefepime were 47.0%(209/445), 43.6%(194/445) and 33.9%(151/445), respectively. And to levofloxacin, cefotaxime and gentamicin were all more than 50%, and to cefuroxime, sulfamethoxazole/trimethoprim pyridine, cefazolin, ciprofloxacin, tetracycline and ampicillin were 61.6% to 89.7%. Drug-resistance rates of 111 strains of Klebsiella pneumoniae to amikacin, piperacillin/tazobactam, ertapenem, imipenem and meropenem were 3.6% to 16.2%, to cefoxitin, levofloxacin, cefepime, ceftazidime, amoxicillin/clavulanate, gentamicin and aztreonam were 34.2% to 48.6%, to cefotaxime, sulfamethoxazole/trimethoprim pyridine, tetracycline, ciprofloxacin and cefuroxime were 58.5% to 72.1%, and to cefazolin, nitrofurantoin and ampicillin were 80.2% to 100%. The main sources of Escherichia coli specimens were department of nephrology wards and outpatient, followed by neurology and endocrinology ward. The main sources of Klebsiella pneumoniae specimens were from Department of Nephrology Wards, followed by neurology ward, ICU and Nephrology Outpatient. Conclusions Drug-resistance rates of common bacteria caused urinary tract infections in our hospital to the most antibacterial drug that commonly used in clinical had certain difference. Specimens mainly distributed in Department of Nephrology and clinicians should use antimicrobial drugs based on susceptibility results.更多还原