贵州医科大学学报

2015, v.40;No.182(11) 1206-1209+1219

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医院泌尿系统感染病原菌的分布及耐药谱
Analysis on Distribution and Drug Resistance of Pathogens in Patients with Urinary Tract Infection in a Hospital of Guizhou province

王欢;孙荣;蒋红清;王涛;
WANG Huan;SUN Rong;JIANG Hongqing;WANG Tao;Department of Electronmicroscopy,Guizhou Medical University;Department of Microbiology,Guizhou Medical University;Editorial Department of Library,Guizhou Medical University;

摘要(Abstract):

目的:探讨医院泌尿系统感染病原菌的分布及耐药谱。方法:收集720例泌尿系感染患者中段晨尿,采用常规方法分离细菌,全自动细菌鉴定和药敏检测系统鉴定病原菌并进行药敏检测,分析泌尿系感染的菌种及其耐药性。结果:获得745株病原菌中G-菌构成比高于G+菌,P<0.05;G-菌中大肠埃希菌最高、其次为肺炎克雷伯菌和铜绿假单胞菌;G+菌中屎肠球菌最高、其次为粪肠球菌和金黄色葡萄球菌;G-杆菌中的大肠埃希菌、肺炎克雷伯菌及阴沟肠杆菌和非发酵菌中铜绿假单胞菌、鲍曼不动杆菌对亚胺培南最敏感,大肠埃希菌、肺炎克雷伯菌及阴沟肠杆菌耐药率最高为氨苄西林、其次为哌拉西林和头孢唑林,铜绿假单胞菌对阿莫西林-克拉维酸、氨苄西林、头孢唑林的耐药率高达100%,鲍曼不动杆菌头对多数常用抗菌药物的耐药率均>60%;G+球菌中的屎肠球菌对19中抗菌药物中11种耐药率>90%,而粪肠球菌中耐药率>90%为5种,2种球菌对亚胺培南、利耐唑胺及呋喃妥因均敏感;葡萄球菌属中金黄色葡萄球菌、溶血葡萄球菌及表皮葡萄球菌对利耐唑胺、呋喃妥因、高浓度链霉素、哌拉西林/他唑巴坦及万古霉素均敏感。结论:本组泌尿系统感染患者病原菌以大肠菌群为主,分离菌株对常用抗生素的耐药现象普遍,但分离菌株中G-菌对亚胺培南较为敏感,G+菌对万古霉素、利耐唑胺较为敏感。
Objective: To investigate the distribution of common pathogens and drug resistance pattern of these pathogens in patients with urinary infections in a hospital from 2012 to 2014. Methods:Bacteria were isolated from 720 cases of patients with urinary infection by the routine bacteriological method. The results of bacteria identification and drug susceptibility test were collected and bacterial distribution and drug resistance pattern were analyzed. Results: The acquired 745 strains of pathogenic bacteria were isolated from urine of patients with urinary system infection. There were 511 strains of gram negative bacteria,accounting for 68. 59% and 234 strains of gram positive bacteria,accounting for 31. 41%. The common pathogenic bacteria were Escherichia coli( 32. 75%),Klebsiella pneumoniae( 12. 89%),Enterococci( 12. 62%),Pseudomonas aeruginosa( 6. 71%),Enterococcus faecalis( 6. 44%) and Enterobacter cloacae( 5. 37%). The drug resistance rates of gram negative bacteria to ampicillin,ceftriaxone,cefotaxime,cefazolin,ampicillin / shubatan,compound sulfamethoxazole were more than 60%. The drug resistance rates of gram positive bacteria to erythromycin,methicillin were more than 65%. Conclusion: The pathogenic bacteria infection in urinary system in the hospital is still dominated by coliform bacteria. The drug resistance is common in clinical isolates,but the gram negative bacteria have a high sensitivity to imipenem and the gram positive bacteria are susceptible to vancomycin and linezolid. It is necessary to monitor and analyze drug resistance of pathogenic bacteria regularly,and provide evidence for rational drug use.

关键词(KeyWords): 泌尿系统感染;病原菌;大肠杆菌;抗生素类;药物耐受,细菌
urinary tract infections;pathogenic bacteria;Escherichia coli;antibiotics;drug resistance,bacteria

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术基金[黔科合J字(2012)2054号]

作者(Author): 王欢;孙荣;蒋红清;王涛;
WANG Huan;SUN Rong;JIANG Hongqing;WANG Tao;Department of Electronmicroscopy,Guizhou Medical University;Department of Microbiology,Guizhou Medical University;Editorial Department of Library,Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2015.11.019

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