郭远瑜, 楚旭, 沈利蒙, 董华丽, 毛剑锋, 张传领. 2008-2012年浙江萧山医院尿路感染患者分离的非发酵菌分布及耐药性分析[J]. 疾病监测, 2013, 28(4): 272-275. DOI: 10.3784/j.issn.1003-9961.2013.4.007
引用本文: 郭远瑜, 楚旭, 沈利蒙, 董华丽, 毛剑锋, 张传领. 2008-2012年浙江萧山医院尿路感染患者分离的非发酵菌分布及耐药性分析[J]. 疾病监测, 2013, 28(4): 272-275. DOI: 10.3784/j.issn.1003-9961.2013.4.007
GUO Yuan-yu, CHU Xu, SHEN Li-meng, DONG Hua-li, MAO Jian-feng, ZHANG Chuan-ling. Distribution and drug resistance of non-fermentative bacteria isolated from patients with urinary tract infection, 2008-2012[J]. Disease Surveillance, 2013, 28(4): 272-275. DOI: 10.3784/j.issn.1003-9961.2013.4.007
Citation: GUO Yuan-yu, CHU Xu, SHEN Li-meng, DONG Hua-li, MAO Jian-feng, ZHANG Chuan-ling. Distribution and drug resistance of non-fermentative bacteria isolated from patients with urinary tract infection, 2008-2012[J]. Disease Surveillance, 2013, 28(4): 272-275. DOI: 10.3784/j.issn.1003-9961.2013.4.007

2008-2012年浙江萧山医院尿路感染患者分离的非发酵菌分布及耐药性分析

Distribution and drug resistance of non-fermentative bacteria isolated from patients with urinary tract infection, 2008-2012

  • 摘要: 目的 调查从尿路感染患者分离的非发酵菌的菌种、临床分布及耐药性,为临床合理选用抗菌药物提供依据。 方法 采用回顾性调查方法,尿液采用经典型浸片Uricult培养,K-B法做药敏试验,利用Whonet 5.6软件对浙江萧山医院2008-2012年尿培养中分离的非发酵菌株进行回顾性分析。 结果 分离非发酵菌146株,主要为铜绿假单胞菌56株(38.4%)、鲍曼不动杆菌36株(24.7%)、洛非不动杆菌16株(11.0%);菌株主要来自泌尿外科(32.9%)和内科(24.7%)患者;铜绿假单胞菌对氨苄西林耐药率为100%,对亚胺培南和美洛培南耐药率分别为19.6%和18.4%;鲍曼不动杆菌对氨苄西林耐药率为97.2%,对头孢噻肟耐药率为69.0%,对亚胺培南和美洛培南耐药率分别为13.9%和20.0%;铜绿假单胞菌和鲍曼不动杆菌对含酶抑制剂头孢哌酮/舒巴坦耐药率较低。 结论 引起尿路感染的非发酵菌以铜绿假单胞菌为主;头孢哌酮/舒巴坦适合作为治疗尿路感染的经验用药,定期监测和分析尿路感染的病原菌分布及耐药性,有助于提高临床经验治愈率及合理用药水平。

     

    Abstract: Objective To understand the distribution and drug resistance of non-fermentative bacteria in patients with urinary tract infection and provide the reference for the rational clinical use of antibiotics. Methods The retrospective survey of drug susceptibility of non-fermentative bacterium strains isolated from the urine specimens of the patients with urinary tract infection in our hospital from 2008 to 2012 and cultured with Uricult. The K-B method was adopted in drug susceptibility test and the result was analyzed with Whonet 5.6 software. Results A total of 146 strains were isolated,in which 56 were Pseudomonas aeruginosa strains (38.4%), 36 were Acinetobacter baumannii strains (24.7%) and 16 were Acinetobacter lwoffii (11.0%). The strains were mainly isolated from the patients in urinary surgery section (32.9%) and internal medicine section (24.7%). The resistant rate of Pseudomonas aeruginosa was 100% to ampicillin, 19.6% to imipenem and 18.4% to meropenem. The resistant rate of Acinetobacter baumannii was 97.2% to ampicillin, 69.0% to cefotaxime, 13.9% to imipenem and 20.0% to meropenem. Pseudomonas aeruginosa and Acinetobacter baumannii showed low resistant rate to enzyme inhibitor cefoperazone/Sulbactam. Conclusion Pseudomonas aeruginosa was the predominant pathogen in the patients with urinary tract infection caused by non-fermentative bacteria; Cefoperazone/sulbactam are suitable for the empiric treatment of urinary tract infection. Regular monitoring and analysis of the distribution and drug resistance of urinary tract infection pathogens would facilitate the improvement of empiric treatment and clinical drug use.

     

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