门诊与住院患者尿路感染病原菌分布及耐药性比较

摘要

目的：探讨门诊与住院患者尿路感染常见病原菌的分布及耐药性，为临床合理使用抗菌药物，有效控制感染提供依据。方法收集2015年诊断为尿路感染的门诊及住院患者的尿液标本进行细菌培养。应用法国生物梅里埃公司Vitek-2鉴定仪对菌株进行鉴定，采用纸片扩散法进行抗菌药物敏感试验，采用WHONET5.6软件进行分析。结果共检出病原菌320株，门诊组共检出11种病原菌，住院组共检出22种病原菌。其中革兰阴性菌均以大肠埃希菌为主，分别占81.7%、48.6%；革兰阳性菌以屎肠球菌为主，分别占43.8%、50.0%。药敏结果显示：大肠埃希菌敏感率较高的是替加环素、头孢替坦、阿米卡星、呋喃妥因和亚胺培南。屎肠球菌敏感率较高的是万古霉素、利奈唑胺。结论尿路感染最常见的病原菌是大肠埃希菌。了解病原菌的临床分布，重视病原菌的耐药性分析，对指导临床合理使用抗生素，控制尿路感染具有重要意义。%ObjectiveTo investigate the distribution and antimicrobial resistance of the pathogens causing urinary tract infection between outpatient and inpatient so as to provide evidence for reasonable clinical use of antibiotics and effective control of infection.MethodsUrine specimens were collected from outpatients and inpatients diagnosed as urinary tract infection during 2015 for pathogen culture. The French bioMerieux Vitek-2 identification instrument was applied for strain identification,the antimicrobial susceptibility test was performed by disk diffusion method and the data were analyzed by WHONET5.6 software.ResultsA total of 320 pathogens were detected including 11 kinds isolated from the outpatient group and 22 kinds from the inpatient group. The gram-negative bacteria especially Escherichia. coli strain was common in both groups,accounted for 81.7% and 48.6% respectively. The gram-positive bacteria especially Enterococcus faecium strain was common in both groups,accounted for 43.8% and 50.0%respectively. Antimicrobial susceptibility test showed that Tigecycline,Cefotetan,Amikacin,Furantoin and Imipenem were susceptible to E.coli. Vancomycin and Linezolid were susceptible to E. faecium.ConclusionE.coli is the most common pathogen in urinary tract infection. The distribution and antimicrobial resistance of the pathogens are of great importance for the clinician application of antibiotics and controlling the urinary tract infection.