摘要
目的了解我国尿路感染细菌分布及耐药状况。方法采用纸片法、MIC法或E-test法，使用WHONET5．4软件进行分析，对卫生部全国细菌耐药性监测网（Mohnarin）所属84家三级甲等医院2006年6月1日～2007年5月31日从尿标本中分离的菌株进行分析。结果①共分离菌株15167株，其中革兰阳性菌4160株，革兰阴性菌11007株，分别占27．4％和72．6％。分离量最多的为大肠埃希菌6838株（45．1％）、肠球菌属2222株（14．7％）和肺炎克雷伯菌1035株（6．8％）；②大肠埃希菌和肺炎克雷伯菌对氟喹诺酮类的耐药率分别为70％和45％；对头孢噻肟耐药率分别为45．2％与42．5％；③屎肠球菌对各种抗菌药物的耐药率明显高于粪肠球菌，粪肠球菌、屎肠球菌中分别有1．2％、3．2％对万古霉素耐药，有1．4％、3．9％对替考拉宁耐药；④表葡菌和金葡菌对头孢西丁的耐药率分别为74．4％和36．oH，未发现对糖肽类中介或耐药的金葡菌，表葡菌对替考拉宁有3．9％的中介率。结论我国尿路感染主要致病菌以大肠埃希菌为代表的革兰阴性杆菌为主，但肠球菌等革兰阳性菌所占比例有所增多；致病菌对喹诺酮类、第三代头孢菌素的耐药率进一步升高。
Objective To determine the bacterial distribution and resistant to antibiotic in urinary tract infections in China. Methods Disc diffusion test, MIC test and E-test were used to study the antimicrobial resistance. WHONET 5.4 was applied for analysis the antibacterial sensitive data from 86 tertiary hospitals of Mohnarin at different area in China from June 1, 2006 to May 31, 2007. Results （1） 15,167 pathogenic strains were collected from urine specimen in the survey period, which included Escherichia coli 6,838 strains （45.1%）, Enterococcus spp. 2,222 strains （14.7%） and Klebsiellia pneumonia 1,035 strains （6.8%）. （2） The resistance rates of E. coli and K. pneumonia to fluoroquinolones were 70% and 45%, and the resistance rates to 3rd generation cephalosporin were 45.2% and 42.5%, respectively. （3） Enterococcus faecium had higher resistance rates to almost all the antibiotics than Enterococcus faecalis. 1.2% E. faecalis and 3.2% E. faecium were resistant to vancomycin, whereas 1.4% and 3.9% were resistant to teicoplanin. （4） Staphylococcus epdermidis were more severe resistance than S. aureus. No S. aureus strains were intermediate or resistant to vancomycin, but the intermediate rate of S. epdermidis to teicoplanin was 3.9%. Conclusion Gram negative bacilli such as E. coli and K. pneumonia were predominant organism in urinary tract infections in China, but Gram positive bacteria such as Entercoccus increased obviously in recent years. The overall and severe bacterial resistance in urinary tract infections need to be concerned and antibiotic rational use should be emphasized.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2008年第10期586-591,634,共7页
Chinese Journal of Antibiotics
