摘要
目的:分析2019-2020年苏州市第九人民医院泌尿系感染患者常见的病原菌分布及耐药性情况,为临床合理使用抗菌药物提供参考依据。方法:采用VITEK2系统鉴定细菌及药物敏感性分析;应用WHONET5.6软件进行数据分析。结果:6120例中段尿细菌培养标本中共检出1893株病原菌,阳性率为30.9%。女性阳性1116例,阳性率为58.9%;男性阳性777例,阳性率为41.1%。革兰阴性菌中,女性检出率高于男性,存在统计学差异(P<0.05);革兰阳性菌中,男性检出率高于女性,存在统计学差异(P<0.05)。排列前5位的病原菌为:大肠埃希菌(47.8%),肺炎克雷伯菌(11.9%),粪肠球菌(8.3%),奇异变形杆菌(5.9%),屎肠球菌(5.0%)。中段尿培养阳性病原菌的科室分布中,排名前三的科室为:泌尿外科、肾内科、ICU。耐药性分析结果显示,肠杆菌科细菌中大肠埃希菌和肺炎克雷伯菌产ESBLs为46.1%、46.2%;产ESBLs菌株对头胞菌素类、喹诺酮类、四环素类、磺胺类等抗菌药物耐药率明显高于非产ESBLs菌株(P<0.05)。检出耐碳青霉烯类抗菌药物的菌株有:5株大肠埃希菌和57株肺炎克雷伯菌。不发酵糖革兰阴性杆菌中铜绿假单胞菌对环丙沙星、阿米卡星、美罗培南和亚胺培南较为敏感;鲍曼不动杆菌对替加环素的敏感率最高,为91.8%。革兰阳性球菌对万古霉素和利奈唑胺仍高度敏感,敏感率为99.0%~100.0%.结论:尿液标本的病原菌多种多样,以大肠埃希菌和肠球菌为泌尿系感染主要致病菌,并且病原菌的耐药性日趋严重。所以定期分析泌尿系感染的病原菌种类及耐药性,对指导临床合理使用抗菌药物具有重要意义。
Objective:To analyze the distribution and drug resistance of common pathogens in patients with urinary tract infection in the Suzhou Ninth People's Hospital from 2019 to 2020 and to provide reference for the rational use of antibacterial drugs in clinical practice.Methods:VITEK2 system was used to identify bacteria and analyze drug sensitivity,and WHONET5.6 software was used for data analysis.Results:A total of 1893 strains of pathogenic bacteria were detected in 6120 samples by midstream urine bacterial culture,and the positive rate was 30.9%.1116 cases were positive in females,with the positive rate of 58.9%;777 cases were positive in males,with the positive rate of 41.1%.The detection rate of gram-negative bacteria was higher in females than in males,and the difierence was statistically significant(P<0.05);While the detection rate of gram-positive bacteria was higher in males than in females,and the difierence was statistically significant(P<0.05).The top five pathogens were:Escherichia coli(47.8%),Klebsiella pneumoniae(11.9%),Enterococcus fkecalis(8.3%),Proteus mirabilis(5.9%),and Enterococcus&ecium(5.0%).The three departments with the highest positive rate of pathogenic bacteria by middle urinary culture were Urology Department,Nephrology Department,and Intensive Care Unit,respectively.Drug resistance analysis showed that among Enterobacteriaceae,ESBLs strains were found in 46.1%of Escherichia coli and 46.2%of Klebsiella pneumoniae.The resistance rate of ESBLs producing strains to cephalosporins,quinolones,tetracyclines,sulfonamides and other antibacterial drugs was significantly higher than that of non-ESBLs producing strains(P<0.05).The detected carbapenem-resistant strains were 5 strains of Escherichia.Coli and 57 strains of Klebsiella pneumoniae.Among the non—fenneiitative sugar gram-negative bacilli,Pseudomonas aeruginosa was more sensitive to ciprofloxacin,amikacin,metronidazole and imipenem;Acinetobacter baumannii had the highest sensitivity rate to tigecycline(91.8%).The gram—positive cocci were
作者
张肖
蔡辉
钮丽萍
ZHANG Xiao;CAI Hui;NIU Li-ping(Department of Laboratory Medicine,the Suzhou Ninth People's Hospital,Jiangsu Wujiang 215200)
出处
《医学检验与临床》
2022年第3期31-37,81,共8页
Medical Laboratory Science and Clinics
关键词
中段尿培养
尿路感染
病原菌
抗菌药物
耐药性
Midstream urine culture
Urinary tract infection
Pathological bacteria
Antimicrobial agent
Resistance
