| 引用本文： |
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周蓉,陈希,徐雅虹,等.泌尿道感染病原菌构成及其耐药性变迁[J].同济大学学报（医学版）,2016,37(5):102-106. [点击复制]
- ZHOU Rong,CHEN Xi,XU Ya-hong,et al.Distribution and antimicrobial resistance of pathogens in urinary tract infections[J].同济大学学报（医学版）,2016,37(5):102-106. [点击复制]
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| 摘要: |
| 目的 了解泌尿道感染的病原菌构成及其耐药性变化,为临床合理使用抗菌药物提供依据。方法 收集我院2013年3月至2014年6月清洁中段尿分离的病原菌作细菌药敏及耐药分析,并与2005年3月至2006年6月的资料比较。结果 8年后,大肠埃希菌构成比仍占首位,但有下降趋势(50.2%降至30.3%),肠球菌仍为第2位(14.4%升至18.5%),白色念珠菌上升至第3位(1.1%升至9.8%),肺炎克雷伯菌无明显变化(7.3%～7.8%),金黄色葡萄球菌有下降趋势(8.7%降至1.2%)。大肠埃希菌(41.4%升至64.5%)、肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)(31.3%升至52.9%)上升。产ESBLs的大肠埃希菌和肺炎克雷伯菌对β-内酰类、喹诺酮类和磺胺类药物耐药率高,且对头孢菌素类抗生素的耐药性有上升趋势,并出现亚胺培南耐药菌。肠球菌对青霉素、红霉素、喹诺酮类、氨基糖甙类抗生素耐药率仍维持在较高水平,对呋喃妥因,万古霉素较敏感。结论 尿路感染常见病原仍为大肠埃希菌和肠球菌,真菌感染不容忽视。应重视产ESBLs菌株的检测。常见的病原菌的耐药现象较为严重。应定期分析泌尿道感染病原菌分布及耐药性的变化以指导抗生素的合理应用。 |
| 关键词: 泌尿道感染 病原菌 耐药性 抗菌药物 |
| DOI：10.16118/j.1008-0392.2016.05.022 |
| 投稿时间：2016-04-27 |
| 基金项目: |
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| Distribution and antimicrobial resistance of pathogens in urinary tract infections |
| ZHOU Rong,CHEN Xi,XU Ya-hong,SHEN Jie,FENG Xue-fang,LU Yuan |
| (Dept.of Nephrology, Yangpu Hospital, Tongji University, Shanghai 200090, China;Dept.of General Medicine, Yangpu Hospital, Tongji University, Shanghai 200090, China) |
| Abstract: |
| Objective To investigate the distribution and drug resistance of pathogens in urinary tract infections (UTI). Methods The distribution and antibiotic resistance of pathogens isolated from urine samples from patients with UTI between March 2013 and June 2014 were analyzed and compared with those between March 2005 to June 2006. Results Escherichia coli remained ranking first in 8 years, but with a downward trend from 50.2% to 30.3%; followed by Enterococcus(from 14.4% to 18.5%) and Candida albicans (from 1.1% to 9.8%). The proportion of klebsiella pneumoniae (KPN) had no significant changes (from 7.3% to 7.8% ) and that of Staphylococcus aureus was declined. The detection rates of extend-spectrum β-lactamases (ESBLs)producing Escherichia coli and klebsiella pneumoniae increased from 41.4% to 64.5% and 31.3% to 52.9%, respectively. ESBLs-producing Escherichia coli and klebsiella pneumoniae showed high resistance rates to most β-lactam, quinolone and aminoglycoside antibiotics; while the resistance rates of cephalosporins increased, and imipenem resistance bacteria were found. The resistance rates of Enterococci to penicillin, erythromycin, quinolone and aminoglycoside antibiotics were still high, while the resistance rates to nitrofurantoin and vancomycin were low. Conclusion Escherichia coli remains to be the major pathogen in urinary tract infections,followed by Enterococcus . Fungal infection should not be ignored and we should take more attention to the detection of ESBLs-producing bacteria. The most common pathogens have high resistance rates.Regular analysis of the bacteria distribution and the changes of drug resistance in UTI is important to guide the proper use of antimicrobial. |
| Key words: urinary tract infections pathogens drug resistance antimicrobial |
