社区卫生服务中心尿路感染病原菌分布及耐药性探析.docVIP

社区卫生服务中心尿路感染病原菌分布及耐药性探析 　　摘 要 目的：了解并分析社区医院住院患者尿路感染的病原菌分布、构成及耐药状况，为指导临床合理使用抗菌药物提供依据。方法：收集2015年1月―2016年1月住院尿路感染患者送检的中段尿标本169份，进行培养、分离、鉴定及药敏分析。结果：169份标本中分别检出革兰阴性杆菌129株（76.3%）、肠球菌属24株（14.2%）、葡萄球菌属13株（7.7%）、真菌3株（1.8%）；产超广谱-内酰胺酶（ESBLs）大肠埃希菌的检出率为39.7%。革兰阴性杆菌对头孢替坦、头孢他啶、头孢吡肟、哌拉西林/他唑巴坦、阿米卡星、亚胺培南的敏感性较好，对氨苄西林、磺胺类抗生素耐药率高；革兰阳性球菌对万古霉素、利奈唑胺敏感。结论：社区住院患者尿路感染的主要病原菌为革兰阴性杆菌，病原菌耐药性较高，真菌感染较少见。临床应结合药敏试验和耐药菌株的检测结果，合理使用抗菌药物 关键词 尿路感染；病原菌；耐药性 中图分类号：R691.3 文献标志码：A 文章编号：1006-1533（2017）02-0022-03 Analysis of the distribution and the drug resistance of pathogenic bacteria of urinary tract infection in the community health service center WANG Jun1， XU Min2， WANG Lingchuang1， XIE Yusu1， BAO Yao1， WANG Xiaohong1， LING Feng1（1.Longhua Community Health Service Center of Xuhui District， Shanghai 200236， China； 2. Central Hospital of Xuhui District， Shanghai 200031， China） ABSTRACT Objective： To understand and analyze the distribution， composition and drug resistance of urinary tract infection of the in-patients in the community hospital to provide the evidence for clinical rational use of antibiotics. Methods： From January 2015 to January 2016， 169 urine specimens from patients with urinary tract infection submitted for censorship were collected for culture， isolation， identification and drug sensitivity analysis. Results： In 169 samples， 129 strains of gram negative bacilli（76.3%）， 24 strains of enterococcus（14.2%）， 13 strains of staphylococcus（7.7%）， and 3 strains of fungi（1.8%） were detected. The detection rate of extended spectrum β lactamases（ESBLs）producing escherichia coli was 39.7%. Gram negative bacilli were sensitive to cefotetan， ceftazidime， cefepime， piperacillin/tazobactam， amikacin and imipenem， while highly resistant to ampicillin and sulfonamides. Gram positive cocci were sensitive to vancomycin and linezolid. Conclusion： The main pathogenic bacteria of urinary tract infection in the community hospital in-patients are gram-negative bacilli， the drug resistance of pathog