尿路感染分离菌1126株耐药性监测

钮博; 刘群; 李梅; 李峰; 陈黎忠; 王敏

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尿路感染分离菌1126株耐药性监测

钮博 , 刘群 , 李梅 , 李峰 , 陈黎忠 , 王敏

文章导航 > 蚌埠医学院学报 > 2010, 35 > 8: (820-822)

引用本文:

Citation:

尿路感染分离菌1126株耐药性监测

1. 蚌埠医学院第二附属医院检验科, 安徽蚌埠 233040;
2. 蚌埠医学院第一附属医院检验科, 安徽蚌垃 233004

作者简介: 钮博(1966-),男,主管检验师.

基金项目:
蚌埠医学院自然科学研究资助项目(BY0540)
中图分类号: R691.3

Observation of bacteria drug resistance in urinary tract infection

1. Department of Clinical Laboratories, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233040;
2. Department of Clinical Laboratories, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China
CLC number: R691.3

摘要: 目的:监测尿路感染患者尿液中分离的病原菌组成及耐药状况。方法:对1126株尿培养分离菌进行鉴定和耐药性分析,特殊耐药株细菌的检测均采用K-B法,并按照CLSI2006年版标准判断敏感率、中介率及耐药率。结果:1126株尿路感染分离菌中大肠埃希菌512株(45.5%),凝固酶阴性葡萄球菌属208株(18.5%),肠球菌属112株(9.9%),白色念珠菌61株(5.4%),变形杆菌55株(4.9%),肺炎克雷伯菌52株(4.6%)以及阴沟肠杆菌、铜绿假单胞菌(棒状杆菌4株、鲍曼不动杆菌等)。其中产超广谱β-内酰胺酶细菌检出率大肠埃希菌为48.0%,肺炎克雷伯菌38.6%,铜绿假单胞菌9.5%,耐甲氧西林凝固酶阴性葡萄球菌78.5%,耐万古霉素肠球菌1.8%,高耐庆大霉素的肠球菌80.4%;仅在大肠埃希菌检出1.4%头孢菌素酶株。碳青霉烯类仍是对G^-杆菌(除嗜麦芽窄食单胞菌与黄杆菌)抗菌作用最强的一类抗生素,头孢哌酮/舒巴坦、哌拉西林/他巴唑坦、头孢吡肟等对G^-菌亦有很好的抗菌活性;G⁺菌耐药率普遍较高,仅对万古霉素保持较好的敏感。结论:大肠埃希菌和凝固酶阴性葡萄球菌是尿路感染的主要病原菌。各种病原菌耐药率呈上升趋势,碳青霉烯类和万古霉素分别对G^-杆菌和G⁺球菌抗菌最好、最强的一类抗生素,值得临床关注。
- 尿路感染 /
- 细菌 /
- 耐药性 /
- 微生物敏感性试验
Abstract: Objective: To monitor the composition and drug resistance of the pathogenic bacteria isolated from the urine of patients with urinary tract infections.Methods: One thousand one hundred and twenty-six drug-resistant bacteria isolated from urine were identified and analyzed,and the special drug-resistant strains were detected by K-B method.The sensitivity rate,intermediate rate and drug resistance rate were determined in accordance with CLSI 2006 standard.Results: Of the 1 126 strains isolated from patients with urinary tract infection,E.coli-based strains accounted for 45.5% (512/1 126),coagulase-negative Staphylococci 18.5% (208/1 126),Enterococcus 9.9% (112/1 126),Candida albicans 5.4% (61/1 126),Mycetozoan 4.9% (55/1 126),Klebsiella pneumoniae 4.6% (52/1 126),and the others were Enterobacter cloacae and Pseudomonas aeruginosa (Corynebacterium 4,such as Acinetobacter baumannii).The detection rate of ESBLs was 48.0% in E.coli,38.6% in Klebsiella pneumoniae,9.5% in Pseudomonas aeruginosa,78.5% in methicillin-resistant staphylococcus aureus,1.8% of vancomycin resistant enterococcal and 80.4% of high level aminoglikozyde resistance.Only 1.4% of Ampc was detected in E.coli strains.Carbapenems was still the most effective antibiotics for gram-negative bacteria (except maltophilia S.m and Flavobacterium).Cefoperazone/sulbactam,piperacillin/tazobactam and cefepime also presented good antibacterial activity.The resistance rate of Gram-positive bacteria was relatively high,only maintaining good sensitivity to vancomycin.Conclusions: Enterobacteriaceae and coagulase-negative staphylococci are the main pathogens for urinary tract infections.The resistant rate of a variety of pathogens tends to rise.Carbon penicillins and vancomycin are the best and strongest antibiotics for gram-negative bacilli and gram-positive cocci respectively,which is worth clinical attention.
- urinary tract infections /
- bacteria /
- drug resistance /
- microbial sensitivity tests

[1]	陈玲 , 张涛 , 顾金花 . 新生儿病房肺炎克雷伯菌感染调查及耐药性分析. 蚌埠医学院学报, 2011, 36(2): 176-178.
[2]	时淑慧 , 钮博 , 王敏 , 边广珠 , 余朝晖 , 李峰 . 尿路感染中大肠埃希菌的耐药性分析. 蚌埠医学院学报, 2010, 35(11): 1145-1146.
[3]	石莹 , 张玉心 , 夏俊 . 产超广谱-内酰胺酶细菌耐药性的检测进展. 蚌埠医学院学报, 2012, 36(1): 122-125.
[4]	胡开明 , 丁后明 , 范海燕 , 杨继忠 . 尿路感染病原菌分布及耐药变化趋势分析. 蚌埠医学院学报, 2014, 38(3): 393-396.
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[6]	闫雳 . 尿路感染大肠埃希菌耐药分析. 蚌埠医学院学报, 2011, 36(10): 1113-1115.
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[9]	徐飞 , 迟富丽 , 谈华 , 刘雪梅 , 阳艳丽 , 钟天鹰 . 南京地区儿童肠道感染致病性大肠埃希菌血清型的分布及耐药性. 蚌埠医学院学报, 2011, 36(12): 1380-1381,1384.
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[13]	张琪 , 程训民 , 朱素珍 , 李敏 . 淮北地区肠杆菌科细菌对21种抗生素的耐药性分析. 蚌埠医学院学报, 2006, 31(3): 295-296.
[14]	李甲 , 姚晓玲 , 郑岚 . 血培养阳性标本细菌分布及耐药性分析. 蚌埠医学院学报, 2016, 41(10): 1360-1362. doi: 10.13898/j.cnki.issn.1000-2200.2016.10.033
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尿路感染分离菌1126株耐药性监测

作者简介: 钮博(1966-),男,主管检验师.

1. 蚌埠医学院第二附属医院检验科, 安徽蚌埠 233040;
2. 蚌埠医学院第一附属医院检验科, 安徽蚌垃 233004

收稿日期: 2009-06-22

基金项目: 蚌埠医学院自然科学研究资助项目(BY0540)

关键词:

摘要: 目的:监测尿路感染患者尿液中分离的病原菌组成及耐药状况。方法:对1126株尿培养分离菌进行鉴定和耐药性分析,特殊耐药株细菌的检测均采用K-B法,并按照CLSI2006年版标准判断敏感率、中介率及耐药率。结果:1126株尿路感染分离菌中大肠埃希菌512株(45.5%),凝固酶阴性葡萄球菌属208株(18.5%),肠球菌属112株(9.9%),白色念珠菌61株(5.4%),变形杆菌55株(4.9%),肺炎克雷伯菌52株(4.6%)以及阴沟肠杆菌、铜绿假单胞菌(棒状杆菌4株、鲍曼不动杆菌等)。其中产超广谱β-内酰胺酶细菌检出率大肠埃希菌为48.0%,肺炎克雷伯菌38.6%,铜绿假单胞菌9.5%,耐甲氧西林凝固酶阴性葡萄球菌78.5%,耐万古霉素肠球菌1.8%,高耐庆大霉素的肠球菌80.4%;仅在大肠埃希菌检出1.4%头孢菌素酶株。碳青霉烯类仍是对G^-杆菌(除嗜麦芽窄食单胞菌与黄杆菌)抗菌作用最强的一类抗生素,头孢哌酮/舒巴坦、哌拉西林/他巴唑坦、头孢吡肟等对G^-菌亦有很好的抗菌活性;G⁺菌耐药率普遍较高,仅对万古霉素保持较好的敏感。结论:大肠埃希菌和凝固酶阴性葡萄球菌是尿路感染的主要病原菌。各种病原菌耐药率呈上升趋势,碳青霉烯类和万古霉素分别对G^-杆菌和G⁺球菌抗菌最好、最强的一类抗生素,值得临床关注。

English Abstract

Observation of bacteria drug resistance in urinary tract infection

1. Department of Clinical Laboratories, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233040;
2. Department of Clinical Laboratories, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

Received Date: 2009-06-22

Abstract: Objective: To monitor the composition and drug resistance of the pathogenic bacteria isolated from the urine of patients with urinary tract infections.Methods: One thousand one hundred and twenty-six drug-resistant bacteria isolated from urine were identified and analyzed,and the special drug-resistant strains were detected by K-B method.The sensitivity rate,intermediate rate and drug resistance rate were determined in accordance with CLSI 2006 standard.Results: Of the 1 126 strains isolated from patients with urinary tract infection,E.coli-based strains accounted for 45.5% (512/1 126),coagulase-negative Staphylococci 18.5% (208/1 126),Enterococcus 9.9% (112/1 126),Candida albicans 5.4% (61/1 126),Mycetozoan 4.9% (55/1 126),Klebsiella pneumoniae 4.6% (52/1 126),and the others were Enterobacter cloacae and Pseudomonas aeruginosa (Corynebacterium 4,such as Acinetobacter baumannii).The detection rate of ESBLs was 48.0% in E.coli,38.6% in Klebsiella pneumoniae,9.5% in Pseudomonas aeruginosa,78.5% in methicillin-resistant staphylococcus aureus,1.8% of vancomycin resistant enterococcal and 80.4% of high level aminoglikozyde resistance.Only 1.4% of Ampc was detected in E.coli strains.Carbapenems was still the most effective antibiotics for gram-negative bacteria (except maltophilia S.m and Flavobacterium).Cefoperazone/sulbactam,piperacillin/tazobactam and cefepime also presented good antibacterial activity.The resistance rate of Gram-positive bacteria was relatively high,only maintaining good sensitivity to vancomycin.Conclusions: Enterobacteriaceae and coagulase-negative staphylococci are the main pathogens for urinary tract infections.The resistant rate of a variety of pathogens tends to rise.Carbon penicillins and vancomycin are the best and strongest antibiotics for gram-negative bacilli and gram-positive cocci respectively,which is worth clinical attention.