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目的了解医院泌尿道感染病原菌的分布及耐药情况,为临床合理使用抗菌药物提供科学依据。方法收集医院泌尿道感染患者尿液标本中分离的156株病原菌,进行细菌鉴定和药敏分析,并对大肠埃希菌和肺炎克雷伯菌进行超广谱β-内酰胺酶(ESBLs)的检测。结果医院泌尿道感染的病原菌主要为革兰阴性(G-)菌72株(46.15%)、其次是真菌55株(35.26%)、革兰阳性(G+)菌29株(18.59%);前5位菌株依次为大肠埃希菌、热带念珠菌、白色念珠菌、粪肠球菌和肺炎克雷伯菌;产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率分别为57.50%、73.33%;病原菌对常用抗菌药物产生多重耐药,G-菌对多黏菌素B 100%敏感,头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、呋喃妥英、碳青酶烯类的敏感率>80.0%,氨卞青霉素、环丙沙星的耐药率>80.0%;G+菌对万古霉素、利奈唑烷100.0%敏感,青霉素G的耐药率>80.0%。结论重视泌尿道感染病原菌及耐药性检测,以药敏试验选用抗菌药物进行治疗十分重要。
Objective To understand the distribution and drug resistance of pathogenic bacteria in urinary tract infection in hospitals and provide a scientific basis for the rational use of antibacterials in clinical practice. Methods A total of 156 strains of pathogens isolated from urine samples from patients with urinary tract infections were collected for bacterial identification and drug susceptibility analysis. ESBLs-producing strains of Escherichia coli and Klebsiella pneumoniae Detection. Results The main pathogens of urinary tract infection in hospital were 72 strains (46.15%) of gram-negative bacteria, followed by 55 strains (35.26%) and 29 strains (18.59%) of gram-positive bacteria The strains were Escherichia coli, Candida tropicalis, Candida albicans, Enterococcus faecalis and Klebsiella pneumoniae. The detection rates of ESBLs-producing Escherichia coli and Klebsiella pneumoniae were 57.50%, 73.33% ; Pathogenic bacteria commonly used antibacterial drugs have multi-drug resistance, G-bacteria sensitive to polymyxin B 100%, cefoperazone / sulbactam, piperacillin / tazobactam, nitrofurantoin, carbapenems The susceptibility of ampicillin and ciprofloxacin was> 80.0%. The sensitivity of G + to vancomycin and linezolid was 100.0%, and that of penicillin G was> 80.0%. Conclusion It is very important to pay attention to the pathogenic bacteria and drug resistance of urinary tract infection and choose antimicrobial drugs for drug sensitivity test.