摘要
泌尿系统感染的临床发病率很高,仅次于呼吸系统感染。对分离的细菌进行鉴定以及药敏试验,有助于了解引起感染的各种细菌分布以及耐药情况。研究患者尿培养病原菌的分布以及临床常用抗生素耐药情况,从而为临床正确、合理使用药物提供参考。回顾分析了辽宁省2017年1月至2021年12月共4 865份尿标本感染菌鉴定结果和大肠埃希菌(Escherichia coli)的药物敏感试验结果,数据来自辽宁省各大医院。采用法国梅里埃VITEK MS全自动快速微生物质谱检测系统和/或VITEK 2 Compact全自动微生物鉴定仪进行菌种鉴定,对来自门诊和住院泌尿系统感染患者尿标本中分离的1 411株大肠埃希菌进行药敏试验分析。结果表明,尿培养的病原菌中主要以革兰阴性菌为主占66.2%,其次为革兰阳性菌。在革兰阴性菌当中大肠埃希菌占37.1%。大肠埃希菌对氨苄西林、环丙沙星、复方新诺明、头孢唑啉的耐药性比较高,每年的耐药率均超过50%,对哌拉西林的耐药率在2021年已经达到100%。而对于阿米卡星、呋喃妥英、美罗培南、哌拉西林/他唑巴坦、头孢替坦和亚胺培南则出现较低的耐药性,五年的耐药率均低于10%。对于临床治疗尿路感染选用的左氧氟沙星、头孢呋辛和头孢曲松三个一线药物,大肠埃希菌对左氧氟沙星的耐药率有逐年上升的趋势,但对头孢呋辛和头孢曲松的耐药率变化不大。上述结果表明,辽宁省近五年尿培养的主要致病菌是革兰阴性菌,其中大肠埃希菌占有的比例很高。大肠埃希菌易产生耐药性,需对其加强监测,通过向临床提供最新最快的耐药性分析资料,可以更好地控制大肠埃希菌导致的感染,为临床合理用药及治疗提供帮助。
Clinical incidence rate of urinary tract infection is very high, second only to respiratory infection. The identification and drug sensitivity test of isolated bacteria are helpful to investigate the distribution and drug resistance of various bacteria causing the infection. To study the distribution of pathogenic bacteria in patients′ urine culture and the resistance of commonly used antibiotics in clinical practice, so as to provide references for correct and rational use of drugs in the clinic. The identification results of infectious bacteria and the drug sensitivity test results of E. coli in 4 865 urine samples from January 2017 to December 2021 in Liaoning Province were analyzed retrospectively, the data were from major hospitals in Liaoning Province. Strains were identified adopted VITEK MS and/or VITEK 2 Compact full-automatic microbial identification instrument of Merier, France, and 1 411 strains of E. coli isolated from outpatients and inpatients with urinary system infection were analyzed by drug sensitivity test. The results showed that Gram-negative bacteria were the main pathogens in urine culture, accounting for 66.2%, followed by Gram-positive bacteria. Among Gram-negative bacteria, E. coli accounted for 37.1%. E. coli has high resistance to ampicillin, ciprofloxacin, compound sulfamethoxazole and cefazolin, and the annual resistance rate was above 50%. In addition, the resistance rate to piperacillin has reached as high as 100% in 2021. For amikacin, furantoin, meropenem, piperacillin/tazobactam, cefotetan and imipenem, the drug resistance rate was lower than 10% in five years. For the three front-line drugs of levofloxacin, cefuroxime and ceftriaxone used in the clinical treatment of urinary tract infection, the resistance rate of E. coli to levofloxacin has an upward trend year by year, but the resistance rate to cefuroxime and ceftriaxone has little change. The above mentioned results showed that the main pathogenic bacteria of urine culture in Liaoning Province in recent 5 years were Gram
作者
王德成
管仲莹
WANG De-cheng;GUAN Zhong-ying(nd Affil.Hosp.,Liaoning Uni.of TCM,Shenyang 110034)
出处
《微生物学杂志》
CAS
CSCD
2022年第5期81-87,共7页
Journal of Microbiology
基金
辽宁省高校优秀人才项目(LJQ2015072)。
关键词
尿路感染
尿培养
病原菌
耐药性
urinary tract infection
urine cultures
pathogens
drug resistance
