[关键词]
[摘要]
目的 分析武汉市普仁医院成人尿路感染病原菌的分布及耐药性,为临床使用抗菌药物提供依据。方法 收集2016年1月-2018年8月尿培养阳性菌株,采用VITEK 2-Compact仪器法或纸片扩散法测定分离菌的药物敏感性,参照CLSI 2017版折点判读结果,用WHONET 5.6软件统计分析。结果 共分离出1 822株病原菌,革兰阴性菌1 318株,构成比为72.34%,主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和奇异变形杆菌;革兰阳性菌430株,构成比为23.60%,主要为粪肠球菌、屎肠球菌、凝固酶阴性葡萄球菌和无乳链球菌;真菌74株,构成比为4.06%,均为念珠菌。革兰阴性菌对亚胺培南、美洛培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦较敏感。屎肠球菌对所测试抗菌药物的耐药率显著高于其他肠球菌,未发现耐万古霉素、替考拉宁、奎奴普丁/达福普汀和利奈唑胺的革兰阳性菌。念珠菌属对所监测抗真菌药物均较敏感。结论 武汉市普仁医院尿路感染病原菌分布广泛,仍以革兰阴性菌为主,建议临床医师根据病原学监测资料有针对性地选择抗生素。
[Key word]
[Abstract]
Objective To analyze the distribution and drug resistance of pathogenic bacteria causing urinary tract infection in adults of Wuhan Puren Hospital, in order to further provide the reference for rational use of antibacterial agents.Methods The strains isolated from the urine in Wuhan Puren Hospital from January 2016 to August 2018 were collected, and the identification and antimicrobial susceptibility were performed by VITEK 2-Compact. Drug resistance was judged according to CLSI 2017 and WHONET 5. 6 software was used to analyze the data.Results A total of 1 822 bacterial strains were isolated, in which Gram-negative (1 318 strains) accounted for 72.34%, and main of them were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis. Gram-positive bacteria bacteria were 430 strains (23.60%), and main of them were Enterococcus faecalis, Enterococcus faecium, coagulase negative staphylococcus, and Streptococcus agalactiae. Fungus were 74 strains, accounted for 4.06%, and all of them were candida. Gram-negative bacilli were sensitive to imipenem, meropenem, piperacillin/tazobactam, and cefoperazone/ sulbactam. The resistance rate of E. faecium to most of the drugs tested was significantly higher than other enterococci. There was no Gram-positive bacilli resistant to vancomycin, teicoplanin, quinupristin/dalfopristin, or linezolid. Candida were sensitive to all drugs tested.Conclusion Urinary tract infection pathogens are widely distributed in Wuhan Puren Hospital. The main pathogen is still Gram-negative bacilli. Doctors should select the antibiotics based on the etiology of monitoring data.
[中图分类号]
[基金项目]