ICU患者尿路感染的病原菌分布及耐药性分析

摘要

Objective To investigate the distribution and drug resistance of common pathogenic bacteria in ICU patients with urinary tract infection so as to provide the basis for rationally selecting the antibacterial drugs in clinic and guiding the clini-cally rational drug use. Methods 225 strains of pathogenic bacteria isolated from the urine samples among ICU patient with uri-nary tract infection in our hospital from January 1, 2013 to December 31,2014 were performed the identification and drug suscep-tibility test. Results Among 225 strains of pathogenic bacteria,119 strains(52.9%) were Gram-negative bacteria,35 strains (15.6%)were Gram-positive bacteria,53 strains(23.6%) were fungi and 18 strains(8.0%) were other bacteria. Gram-positive bacte-ria were sensitive to both vancomycin(VA) and linezolid(LZD),Gram-negative bacteria were sensitive to both imipenem(IPM) and meropenem(MEM),and fungi were sensitive to amphotericin B(AMPHO) and nystatin(NYST). In ESBLs producing bacteria, Escherichia coli was predominant,its detection rate was 47.7%(21/44). Conclusion Gram-negative bacteria are the major pathogens in urinary tract infection and their resistance to commonly used antibacterial drugs shows the upward trend ,which has important significance to guide rational use of antibacterial drugs in clinic and select effective antibacterial drugs.%目的：探讨医院重症监护病房（ICU）尿路感染常见病原菌的分布及其耐药特性，以便更好地为临床合理选用抗菌药物提供依据，指导临床合理用药。方法对2013年1月1日至2014年12月31日该院ICU收治的尿路感染患者尿液标本分离出的225株病原菌进行鉴定和药敏分析。结果225株病原菌中革兰阴性菌119株（52.9%），革兰阳性球菌35株（15.6%），真菌53株（23.6%），其他18株（8.0%）。革兰阳性球菌对万古霉素、利奈唑胺均敏感；革兰阴性菌对亚胺培南、美罗培南均敏感；真菌对两性霉素B、制霉菌素均敏感。产超广谱β-内酰胺酶（ESBLs）菌株以大肠埃希菌为主，检出率为47.7%（21/44）。结论革兰阴性菌为尿路感染的主要病原菌，对常用抗菌药物耐药率呈上升趋势，对指导临床合理使用抗菌药物、选择有效抗菌药物治疗具有重要意义。