摘要
目的探讨广州黄埔区三家医院尿培养分离菌的分布特点及耐药性,为临床合理使用抗菌药物提供参考。方法收集2013年1月-2016年6月广州黄埔区三家综合性三甲医院的中段尿标本分离菌2 978株,采用全自动微生物鉴定/药敏测试系统对分离菌株进行细菌鉴定及药敏试验,观察分析病原菌分布特点及耐药性情况。结果 2 978株病原菌中革兰阳性菌546株占18.33%、革兰阴性菌2 432株占81.67%;居前四位的病原菌分别为大肠埃希菌、肺炎克雷伯菌、粪肠球菌、铜绿假单胞菌,分别占46.68%、12.29%、9.64%、6.01%;粪肠球菌对呋喃妥因、利奈唑胺、万古霉素及替加环素耐药率较低,均<10%,屎肠球菌对氨苄西林、高浓度庆大霉素、高浓度链霉素、利福平、环丙沙星、磺胺甲噁唑/甲氧苄啶的耐药率较高,均>60%;产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌检出率分别为61.01%(848/1390)和53.01%(194/366);肠杆菌科细菌对碳青霉烯类抗菌药物较敏感。结论尿培养分离病原菌以革兰阴性菌为主,耐药菌株分离率高,定期监测和分析尿培养分离病原菌的分布特点及耐药性变化,对指导临床合理使用抗菌药物具有重要意义。
OBJECTIVE To investigate the distribution and antibiotic resistance of clinical isolates from urinary culture 3 hospitals in Huangpu district of Guangzhou,so as to provide references for clinical rational use of antimicrobial agents.METHODS A total of 2978 strains of urinary culture isolated from all three comprehensive tertiary hospitals in Huangpu district of Guangzhou from Jan.2013 to Jun.2016 were collected.The identification and drug sensitivity test of the isolated strains were carried out by automatic microbiological identification/drug sensitivity test system,and the distribution and drug resistance of the pathogenic bacteria were observed and analyzed.RESULTS A total of 2978 isolates were isolated,of which gram-negative bacteria accounted for 81.67%（2 432 strains）and gram-positive bacteria accounted for 18.33%（546 strains）.The top four isolates were Escherichia coli,Klebsiella pneumoniae,Enterococcus faecalis and Pseudomonas aeruginosa,accounting for 46.68%,12.29%,9.64%,and 6.01%,respectively.The resistant rates of Enterococcus faecalis to furotomide,linezolid,vancomycin and tetracycline were low,which were all below 10%,and the resistant rates of Enterococcus faecium to ampicillin,high concentration of gentamicin,high concentration of streptomycin,rifampicin,ciprofloxacin and sulfamethoxazole/trimethoprim were high,which were all greater than 60%.The detection rates of extendedspectrumβ-lactamase-producing（ESBLs）E.coli and K.pneumoniae were 61.01%（848/1390）and 53.01%（194/366）,respectively.Enterobacteriaceae were sensitive to carbapenems.CONCLUSIONGram-negative bacteria are the main pathogens in urine culture,and the isolation rate of bacteria with antibiotic resistance is high.It is important to monitor and analyze the composition and antibiotic resistance changes of urine culture isolates regularly to guide rational use of antibiotics in clinic.
作者
蔡小华
李晖婷
朱柏珍
李晓杰
吴林丽
CAI Xiao-hua;LI Hui-ting;ZHU Bai-zhen;LI Xiao-jie;WU Lin-li(The Estern Hospital of The First Affiliated Hospital , Sun Yat-sen University , Guangzhou , Guangdong 510700, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第7期1027-1029,1036,共4页
Chinese Journal of Nosocomiology
关键词
尿路感染
尿培养
病原菌
耐药性
Urinary tract infection
Urine culture
Isolated bacteria
Drug resistance
