中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2012年
2期
132-137
,共6页
杨春霞%陈山%杨勇%刘颖梅%王辉%王占伟%杨启文%黎斌斌%栗方%王珊珊%王春雷%曲久鑫%刘振嘉%乔庐东%曹彬
楊春霞%陳山%楊勇%劉穎梅%王輝%王佔偉%楊啟文%黎斌斌%慄方%王珊珊%王春雷%麯久鑫%劉振嘉%喬廬東%曹彬
양춘하%진산%양용%류영매%왕휘%왕점위%양계문%려빈빈%률방%왕산산%왕춘뢰%곡구흠%류진가%교려동%조빈
泌尿道感染%社区获得性感染%抗菌药%病原菌%体外研究
泌尿道感染%社區穫得性感染%抗菌藥%病原菌%體外研究
비뇨도감염%사구획득성감염%항균약%병원균%체외연구
Urinary tract infections%Community-acquired infections%Anti-bacterial agents%Pathogens%In vitro
目的 了解北京地区社区获得性单纯性泌尿系感染病原菌的分布及其对常用抗菌药物的体外抗菌活性.方法 随机收集首都医科大学附属北京朝阳医院、北京大学人民医院和北京协和医院2010年1月1日至2011年3月31日300株社区获得性单纯性泌尿系感染的所有病原菌,用肉汤稀释法检测阿米卡星、头孢克洛、头孢吡肟、头孢哌酮/舒巴坦、环丙沙星、左氧氟沙星、庆大霉素、呋喃妥因8种抗生素对病原菌的体外抗菌活性；用琼脂稀释法检测磷霉素氨丁三醇对病原菌的体外抗菌活性；用双纸片协同法检测产超广谱β-内酰胺酶( extended-spectrum β-lactamase,ESBLs)的病原菌. 结果 肠杆菌科细菌仍是单纯性泌尿系感染的主要病原菌(232株,77.3％).300株分离的病原菌中,大肠埃希菌分离率最高(195株,65.0％),其余依次为肠球菌(35株,11.7％)、葡萄球菌(19株,6.3％)、肺炎克雷伯菌(16株,5.3％)、奇异变形杆菌(14株,4.7％)、铜绿假单胞菌(9株,3.0％)等.242株革兰阴性菌对阿米卡星、头孢哌酮/舒巴坦、呋喃妥因和磷霉素氨丁三醇的敏感率分别为92.1％、92.1％、88.4％、87.9％,对环丙沙星和左氧氟沙星的敏感率分别为34.7％和38.4％；葡萄球菌对阿米卡星、头孢哌酮/舒巴坦和呋喃妥因的敏感率分别为100.0％、94.7％和100.0％,对环丙沙星和左氧氟沙星的敏感率均为47.4％；肠球菌对呋喃妥因和磷霉素氨丁三醇的敏感率分别为91.4％和90.0％,对环丙沙星和左氧氟沙星的敏感率均为31.4％.232株肠杆菌科细菌中,111株(47.8％)产ESBLs,其中大肠埃希菌102株,肺炎克雷伯菌7株,奇异变形杆菌2株. 结论 北京地区社区获得性单纯性泌尿系感染病原菌对喹诺酮类药物的敏感率较低,对阿米卡星、头孢哌酮/舒巴坦、呋喃妥因和磷霉素氨丁三醇的敏感性较高,上述4种药物可作为治疗单纯性泌尿系感染的经验抗菌药物.
目的 瞭解北京地區社區穫得性單純性泌尿繫感染病原菌的分佈及其對常用抗菌藥物的體外抗菌活性.方法 隨機收集首都醫科大學附屬北京朝暘醫院、北京大學人民醫院和北京協和醫院2010年1月1日至2011年3月31日300株社區穫得性單純性泌尿繫感染的所有病原菌,用肉湯稀釋法檢測阿米卡星、頭孢剋洛、頭孢吡肟、頭孢哌酮/舒巴坦、環丙沙星、左氧氟沙星、慶大黴素、呋喃妥因8種抗生素對病原菌的體外抗菌活性；用瓊脂稀釋法檢測燐黴素氨丁三醇對病原菌的體外抗菌活性；用雙紙片協同法檢測產超廣譜β-內酰胺酶( extended-spectrum β-lactamase,ESBLs)的病原菌. 結果 腸桿菌科細菌仍是單純性泌尿繫感染的主要病原菌(232株,77.3％).300株分離的病原菌中,大腸埃希菌分離率最高(195株,65.0％),其餘依次為腸毬菌(35株,11.7％)、葡萄毬菌(19株,6.3％)、肺炎剋雷伯菌(16株,5.3％)、奇異變形桿菌(14株,4.7％)、銅綠假單胞菌(9株,3.0％)等.242株革蘭陰性菌對阿米卡星、頭孢哌酮/舒巴坦、呋喃妥因和燐黴素氨丁三醇的敏感率分彆為92.1％、92.1％、88.4％、87.9％,對環丙沙星和左氧氟沙星的敏感率分彆為34.7％和38.4％；葡萄毬菌對阿米卡星、頭孢哌酮/舒巴坦和呋喃妥因的敏感率分彆為100.0％、94.7％和100.0％,對環丙沙星和左氧氟沙星的敏感率均為47.4％；腸毬菌對呋喃妥因和燐黴素氨丁三醇的敏感率分彆為91.4％和90.0％,對環丙沙星和左氧氟沙星的敏感率均為31.4％.232株腸桿菌科細菌中,111株(47.8％)產ESBLs,其中大腸埃希菌102株,肺炎剋雷伯菌7株,奇異變形桿菌2株. 結論 北京地區社區穫得性單純性泌尿繫感染病原菌對喹諾酮類藥物的敏感率較低,對阿米卡星、頭孢哌酮/舒巴坦、呋喃妥因和燐黴素氨丁三醇的敏感性較高,上述4種藥物可作為治療單純性泌尿繫感染的經驗抗菌藥物.
목적 료해북경지구사구획득성단순성비뇨계감염병원균적분포급기대상용항균약물적체외항균활성.방법 수궤수집수도의과대학부속북경조양의원、북경대학인민의원화북경협화의원2010년1월1일지2011년3월31일300주사구획득성단순성비뇨계감염적소유병원균,용육탕희석법검측아미잡성、두포극락、두포필우、두포고동/서파탄、배병사성、좌양불사성、경대매소、부남타인8충항생소대병원균적체외항균활성；용경지희석법검측린매소안정삼순대병원균적체외항균활성；용쌍지편협동법검측산초엄보β-내선알매( extended-spectrum β-lactamase,ESBLs)적병원균. 결과 장간균과세균잉시단순성비뇨계감염적주요병원균(232주,77.3％).300주분리적병원균중,대장애희균분리솔최고(195주,65.0％),기여의차위장구균(35주,11.7％)、포도구균(19주,6.3％)、폐염극뢰백균(16주,5.3％)、기이변형간균(14주,4.7％)、동록가단포균(9주,3.0％)등.242주혁란음성균대아미잡성、두포고동/서파탄、부남타인화린매소안정삼순적민감솔분별위92.1％、92.1％、88.4％、87.9％,대배병사성화좌양불사성적민감솔분별위34.7％화38.4％；포도구균대아미잡성、두포고동/서파탄화부남타인적민감솔분별위100.0％、94.7％화100.0％,대배병사성화좌양불사성적민감솔균위47.4％；장구균대부남타인화린매소안정삼순적민감솔분별위91.4％화90.0％,대배병사성화좌양불사성적민감솔균위31.4％.232주장간균과세균중,111주(47.8％)산ESBLs,기중대장애희균102주,폐염극뢰백균7주,기이변형간균2주. 결론 북경지구사구획득성단순성비뇨계감염병원균대규낙동류약물적민감솔교저,대아미잡성、두포고동/서파탄、부남타인화린매소안정삼순적민감성교고,상술4충약물가작위치료단순성비뇨계감염적경험항균약물.
Objective To investigate the distribution and susceptibility patterns of common uropathogens causing community-acquired urinary tract infection (UTI) in Beijing. Methods A total of 300non-duplicate isolates were randomly collected from 3 hospitals in Beijing between Jan,1 2010 and Mar,312011.Minimal inhibitory concentrations (MICs) were determined by the broth microdilution methods,which were performed and interpreted according to the guidelines established by the Clinical and Laboratory Standards Institute (CLSI).A panel of 8 antimicrobial agents were tested:amikacin,cefaclor,cefepime,cefoperazone/sulbactam,ciprofloxacin,levofloxacin,gentamicin and nitrofurantoin. Fosfomycin trometamol MICs were determined by the agar-dilution method in cation-adjusted MH agar supplemented with glucose 6-phosphate at a concentration of 25 mg/L as detailed in the guidelines issued by 2010 CLSI. All the Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis strains were screened and confirmed by double-disk synergy test for extended-spectrum β-lactamase (ESBLs). Results Among the organisms cultured,E.coli was the predominant pathogen (65.0％ ), followed by Enterococcus (11.7％ ),Staphylococcus ( 6.3％ ), Klebsiella pneumoniae ( 5. 3％ ), Proteus mirabilis ( 4. 7％ ), and Pseudomonas aeruginosa (3.0％).Lower susceptibility rates to ciprofloxacin and levofloxacin (31.4％ -47.4％ ) were observed among all the stains.Amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol were the most active drugs (92.1％,92.1％,88.4％ and 87.9％ susceptible strains,respectively) among the Gram-negative strains.Isolates of Staphylococcus were highly sensitive to amikacin ( 100.0％ ),cefoperazone/sulbactam (94.7％),nitrofurantoin ( 100.0％ ).Higher susceptibility rates to nitrofurantoin (91.4％) and fosfomycin trometamol (90.0％) were observed in Enterococcus.ESBLs-producing strains accounted for 52.3％ (102/195) in E.coli,43.8％ (7/16) in K.pneumoniae and 14.3％(2/14) in P.mirabilis,respectively. Conclusions Resistance is most common to ciprofloxacin and levofloxacin of all the stains.Currently,the most appropriate agents for the empirical management of uncomplicated UTI seems to be amikacin,cefoperazone/sulbactam,nitrofurantoin and fosfomycin trometamol.
