摘要
目的分析疑似尿路感染患者中段尿样本培养的病原菌分布和耐药性,为尿路感染的诊断和治疗工作提供研究依据。方法选取2014年5月-2018年5月医院检验科接收的2 852份疑似尿路感染患者中段尿样本,采用VITEK-2 compact全自动微生物鉴定系统进行病原菌鉴定,采用纸片扩散法(K-B法)进行药敏试验,对病原菌分布和耐药性进行回顾性分析。结果共908份样本检出病原菌,阳性率为31.84%;检出1 088株病原菌,其中,革兰阴性菌773株占71.05%,革兰阳性菌221株占20.31%,真菌94株占8.64%。检出病原菌的中段尿标本来源以泌尿外科、肾内科、重症监护病房为主,构成比分别为30.73%、16.30%和13.33%。主要革兰阴性菌对氨苄西林、哌拉西林、环丙沙星、左氧氟沙星、磺胺甲噁唑/甲氧苄啶、头孢噻肟的耐药率较高,对阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药率较低;革兰阳性菌对红霉素、四环素、庆大霉素、链霉素的耐药率较高,对呋喃妥因、替考拉宁、氯霉素的耐药率较低;耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌及肺炎克雷伯菌和奇异变形菌的检出率分别为50.00%、61.11%、53.13%、34.04%。结论疑似尿路感染患者中段尿样本中的病原菌以大肠埃希菌和铜绿假单胞菌等革兰阴性菌为主,病原菌的耐药性较强,临床医师应对中段尿样本中病原学检测结果给予高度的重视,根据药敏试验结果选用敏感性抗菌药物进行治疗,尽量减少病原菌耐药现象的出现。
OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from midstream urine specimens of patients with suspected urinary tract infection so as to provide guidance for diagnosis and treatment of the urinary tract infection.METHODS A total of 2 853 midstream urine specimens were collected from the patients with suspected urinary tract infection by the clinical laboratory department from May 2014 to May 2018.The pathogens were identified by using VITEK-2 compact automatic microorganism identification system,the drug susceptibility testing was carried out by means of disk diffusion method(K-B)method,and the distribution and drug resistance of the pathogens were observed.RESULTS The pathogens were isolated from 908 specimens,with the positive rate 31.84%.Totally 1 088 strains of pathogens were isolated,773(71.05%)of which were gram-negative bacteria,221(20.31%)were gram-positive bacteria,and 94(8.64%)were fungi.Among the midstream urine specimens that were detected positive for pathogens,30.73%were collected from urinary surgery department,16.30%were collected from nephrology department,and 13.33%were collected from intensive care unit.The drug resistance rates of the main gram-negative bacteria to ampicillin,piperacillin,ciprofloxacin,levofloxacin,sulfamethoxazole/trimethoprim and cefotaxime were high;the drug resistance rates to amikacin,cefoperazone-sulbactam and piperacillin-tazobactam were low.The drug resistance rates of the gram-positive bacteria to erythromycin,tetracycline and streptomycin were high;the drug resistance rates to nitrofurantoin,teicoplanin and chloramphenicol were low.The isolation rates of methicillin-resistant Staphylococcus aureus,extended-spectrumβ-lactamases(ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were 50.00%,61.11%,53.13%and 34.04%,respectively.CONCLUSION The gram-negative bacteria such as E.coli and Pseudomonas aeruginosa are dominant among the pathogens isolated from the midstream urine specimens of the patients with su
作者
顾丽娜
司元国
马广雁
丁建
张肖
孙滨
GU Li-na;SI Yuan-guo;MA Guang-yan;DING Jian;ZHANG Xiao;SUN Bin(Qingdao Haici Medical Group,Qingdao,Shandong266033,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第18期2787-2791,共5页
Chinese Journal of Nosocomiology
基金
山东省科学计划基金资助项目(201602A082)
关键词
尿路感染
中段尿
病原菌分布
耐药性
Urinary tract infection
Midstream urine
Distribution of pathogen
Drug resistance
