尿标本及非尿标本菌谱比较及其耐药分析.docVIP

尿标本及非尿标本菌谱比较及其耐药分析 　【摘要】 目的 比较尿与非尿标本的菌谱及其耐药性的不同，探讨监测中存在的不足，指导临床合理使用抗生素。方法 采用天地人生化药敏试验卡对阳性株进行鉴定和药物敏感试验，采用WHONET5.3软件对药物敏感试验数据进行分析。结果 894例阳性尿标本中：大肠埃希菌占24.4%，粪肠球菌占18.1%，金黄色葡萄球菌占8.7%，白色念珠菌占7.2%。2986例阳性非尿标本中，大肠埃希菌占7.3%，粪肠球菌占3.37%，金黄色葡萄球菌占27.3%，白色念珠菌占8.9%；尿标本中，大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌对喹诺酮类药物的敏感性，明显低于非尿分离株，金黄色葡萄球菌对大环内酯类药物的敏感性高于非尿标本；经济型的药物象作用于革兰阳性球菌的利福平、强力霉素；作用于革兰阴性杆菌的呋喃妥因、磷霉素都有很高的敏感率。结论 由于尿与非尿标本菌谱及其耐药性的不同，应该多加强耐药监测，指导临床用药。 【关键词】 菌谱;耐药监测 Comparation of distribution of pathogens and analyzation of antimicrobial resistance between urine samples and no-urine sample 【Abstract】 Objective To compare the distribution patterns and analyze the antimicrobial resistance between the urine samples and no-urine samples，and to explore the problems in the surveillance；in order to select antibiotics correctly according to the results.Methods TianDiRen were used to study the antimicrobial resistance and bacteria indentification.The data were analyzed by WHONET5.3 software.Results Among the 894 urine clinical isolates，the distribution incidence of Escherichia coli，enterococcus faecalis，Staphylococcus aurous，Candid albicans was 24.4%，18.1%，8.7%，7.2% respectively.Among the 2986 no-urine clinical isolates，the distribution incidence of Escherichia Coli，Enterococcus faecalis，Staphylococcus aureus，Candid albicans was 7.3%，3.37%，27.3%，8.9% respectively; for Escherichia coil，Staphylococcus aurens，Klebsiella pneumoniae to the susceptibility of quinolones，there are some significant differences ;Staphylococcus aureus was higher susceptible to macrolides in the urine sample than in the non-urine samples，the cheaper antibiotics，for example，rifampine，doxycycline，fostomycin nitrofurantoins were lower resistance.Conclusion In order to select antibiotics correctly，it is important to understand the difference of distribution of pathogens and to survey antibiotics resistance. 【Key words】 distribution of pathogens;antimicrobial resistance surveillance 由于泌尿感染与非泌尿感染经验选用抗生素种类不一样，以及临床抗生素的滥用；在抗生素的选择性压力下，病原菌