摘要
目的 分析尿路感染病原菌的分布特征,检验临床耐药性以期为临床合理用药提供依据.方法 采用药敏分析试验对2021年8月至2023年8月我院收治患者的中段尿液进行培养,分离细菌及真菌后进行鉴定,进而统计尿路感染病原菌的分布情况与耐药性.结果 235例患者尿液标本中共培养337株病原菌,其中大肠埃希菌、肺炎克雷伯菌是占比较多的革兰阴性菌,分别占比73.9％(190/257)、8.9％(23/257);屎肠球菌、粪肠球菌分别占比10.3％、6.9％,是革兰阳性菌中占比较多的菌株;真菌在标本中占比较低,共25株,占比7.4％;大肠埃希菌、肺炎克雷伯菌、变形杆菌等菌种主要分布泌尿外科77株,肾内科60株,内分泌科48株,综合内科33株,心血管内科27株,神经内科28株,骨科24株,消化内科20株,神经外科17株,呼吸内科14株,门诊11株,其他病区12株.所有菌株对哌拉西林、阿莫西林/克拉维酸、头孢哌酮/舒巴坦、替卡西林/克拉维酸的耐药性均较高,其中检出率最高的大肠埃希菌对上述药物的耐药性分别为23.2％(44/190)、19.5％(37/190)、14.7％(28/190)、3.0％(17/190).屎肠球菌、粪肠球菌对青霉素G、氨苄西林、高浓度庆大霉素等药物均存在耐药性,屎肠球菌的耐药性均高于粪肠球菌.结论 尿路感染病原菌以革兰阳性菌、革兰阴性菌为主,病原菌在各个科室均有分布,其中大肠埃希菌、屎肠球菌的耐药性较高.
Abstract
Objective To analyze the distribution characteristics of pathogenic bacteria in urinary tract infections and test clinical drug resistance in order to provide accurate data for rational drug use in clinical practice.Methods Drug sensitivity analysis was used to culture the middle urine of patients admitted to our hospital from August 2021 to August 2023.Bacteria and fungi were isolated and identified,and the distribution and drug resistance of urinary tract infection pathogens were statistically analyzed.Results A total of 337 strains of pathogenic bacteria were cultured in the urine samples of 235 patients,among which Escherichia coli and Klebsiella pneumoniae were the most common Gram negative bacteria,accounting for 73.9％(190/257)and 8.9％(23/257)respectively;Enterococcus faecalis and Enterococcus faecalis account for 10.3％and 6.9％respectively,making them the most common strains of Gram positive bacteria;Fungi account for a relatively low proportion in the specimens,with a total of 25 strains,accounting for 7.4％.Escherichia coli,Klebsiella pneumoniae,Proteus,and other bacterial strains are mainly distributed in multiple departments such as urology,nephrology,endocrinology,and comprehensive medicine.There were 77 strains in urology,60 strains in nephrology,48 strains in endocrinology,33 strains in comprehensive medicine,27 strains in cardiovascular medicine,28 strains in neurology,24 strains in orthopedics,20 strains in gastroenterology,17 strains in neurosurgery,14 strains in respiratory medicine,11 strains in outpatient department,and 12 strains in other wards.All strains have high resistance to piperacillin,amoxicillin/clavulanic acid,cefoperazone/sulbactam,and ticarcillin/clavulanic acid.Among them,Escherichia coli with the highest detection rate has resistance to the above drugs at 23.2％(44/190),19.5％(37/190),14.7％(28/190)and 9.0％(17/190),respectively.Both Enterococcus faecalis and Enterococcus faecalis have resistance to drugs such as penicillin G,ampicillin,and high concentrations of gentamicin.The resistance of Enterococcus faecalis is higher than that of Enterococcus faecalis.Conclusion The main pathogens of urinary tract infections are Gram positive and Gram negative bacteria,which are distributed in various departments.Among them,Escherichia coli and Enterococcus faecalis have higher drug resistance.
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