中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2014年
2期
105-110
,共6页
凌华志%沈继录%王中新%徐元宏
凌華誌%瀋繼錄%王中新%徐元宏
릉화지%침계록%왕중신%서원굉
泌尿道感染%抗药性%细菌%真菌
泌尿道感染%抗藥性%細菌%真菌
비뇨도감염%항약성%세균%진균
Urinary tract infections%Drug resistance%Bacteria%Fungi
目的 了解泌尿系感染病原菌分布及其耐药性,为尿路感染的诊治提供参考.方法 连续收集2012年4月至2013年3月安徽医科大学第一附属医院门诊及住院患者的6 262份清洁中段尿样本,按操作规程分离培养,采用MicroScan WalkAway 96 Plus及Vitek 2 Compact全自动微生物鉴定及药敏系统进行细菌的鉴定及药敏.用WHONET 5.6软件和SPSS 20.0分别进行耐药性分析和门诊与住院患者分离菌株耐药率比较.结果 共检出l 426株病原菌,其中革兰阳性球菌占25.9％(370株),革兰阴性杆菌占66.1％(942株),真菌占8.0％(114株).革兰阴性杆菌前二位病原菌为大肠埃希菌和肺炎克雷伯菌,革兰阳性球菌以屎肠球菌和粪肠球菌最多见.病原菌对各种抗菌药物表现出不同的耐药性,革兰阴性杆菌中大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌产超广谱β-内酰胺酶(ESBLs)检出率分别为60.5％,51.0％和30.3％;革兰阳性球菌中耐甲氧西林金黄色葡萄球菌及耐甲氧西林凝固酶阴性葡萄球菌的检出率分别为73.3％和86.7％.泌尿系感染常见真菌以白假丝酵母菌和光滑假丝酵母菌多见,其菌株总体耐药率不高.结论 泌尿系感染病原菌以大肠埃希菌为代表的革兰阴性杆菌为主,细菌耐药性形势严峻,有必要建立一个耐药性监测系统.
目的 瞭解泌尿繫感染病原菌分佈及其耐藥性,為尿路感染的診治提供參攷.方法 連續收集2012年4月至2013年3月安徽醫科大學第一附屬醫院門診及住院患者的6 262份清潔中段尿樣本,按操作規程分離培養,採用MicroScan WalkAway 96 Plus及Vitek 2 Compact全自動微生物鑒定及藥敏繫統進行細菌的鑒定及藥敏.用WHONET 5.6軟件和SPSS 20.0分彆進行耐藥性分析和門診與住院患者分離菌株耐藥率比較.結果 共檢齣l 426株病原菌,其中革蘭暘性毬菌佔25.9％(370株),革蘭陰性桿菌佔66.1％(942株),真菌佔8.0％(114株).革蘭陰性桿菌前二位病原菌為大腸埃希菌和肺炎剋雷伯菌,革蘭暘性毬菌以屎腸毬菌和糞腸毬菌最多見.病原菌對各種抗菌藥物錶現齣不同的耐藥性,革蘭陰性桿菌中大腸埃希菌、肺炎剋雷伯菌、奇異變形桿菌產超廣譜β-內酰胺酶(ESBLs)檢齣率分彆為60.5％,51.0％和30.3％;革蘭暘性毬菌中耐甲氧西林金黃色葡萄毬菌及耐甲氧西林凝固酶陰性葡萄毬菌的檢齣率分彆為73.3％和86.7％.泌尿繫感染常見真菌以白假絲酵母菌和光滑假絲酵母菌多見,其菌株總體耐藥率不高.結論 泌尿繫感染病原菌以大腸埃希菌為代錶的革蘭陰性桿菌為主,細菌耐藥性形勢嚴峻,有必要建立一箇耐藥性鑑測繫統.
목적 료해비뇨계감염병원균분포급기내약성,위뇨로감염적진치제공삼고.방법 련속수집2012년4월지2013년3월안휘의과대학제일부속의원문진급주원환자적6 262빈청길중단뇨양본,안조작규정분리배양,채용MicroScan WalkAway 96 Plus급Vitek 2 Compact전자동미생물감정급약민계통진행세균적감정급약민.용WHONET 5.6연건화SPSS 20.0분별진행내약성분석화문진여주원환자분리균주내약솔비교.결과 공검출l 426주병원균,기중혁란양성구균점25.9％(370주),혁란음성간균점66.1％(942주),진균점8.0％(114주).혁란음성간균전이위병원균위대장애희균화폐염극뢰백균,혁란양성구균이시장구균화분장구균최다견.병원균대각충항균약물표현출불동적내약성,혁란음성간균중대장애희균、폐염극뢰백균、기이변형간균산초엄보β-내선알매(ESBLs)검출솔분별위60.5％,51.0％화30.3％;혁란양성구균중내갑양서림금황색포도구균급내갑양서림응고매음성포도구균적검출솔분별위73.3％화86.7％.비뇨계감염상견진균이백가사효모균화광활가사효모균다견,기균주총체내약솔불고.결론 비뇨계감염병원균이대장애희균위대표적혁란음성간균위주,세균내약성형세엄준,유필요건립일개내약성감측계통.
Objective To investigate the distribution and drug resistance of pathogens isolated from urinary tract infections.Methods A total of 6 262 midstream urine samples were collected from patients in the First Alfiliated Hospital of Anhui Medical University during April 2012 and March 2013.MicroScan WalkAway 96 Plus or Vitek 2 Compact system was applied in bacteria identification and drug sensitivity test.WHONET 5.6 was adopted to analyze drug resistance,and IBM SPSS 20.0 was applied to compare resistance rates between isolates from outpatients and hospitalized patients.Results A total of 1 426 strains were isolated,in which 370 strains were gram-positive coccus (25.9％),942 strains were gram-negative bacilli (66.1％) and 114 strains were fungi (8.0％).Escherichia coli and Klebsiella pneumoniae,Enterococcus faecium and Enterococcus faecalis were the top two among gram-negative bacilli and grampositive coccus,respectively.The prevalence of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were 60.5％,51.0％ and 30.3％,respectively; About 73.3％ of Staphylococcus aureus strains and 86.7％ of coagulase-negative Staphylococcus strains were methicillin-resistant.Candida albicans and Candida glabrata were the two most prevalent fungi in urinary tract infections,and they were sensitive to most antifungal agents.Conclusion Gram-negative bacilli,especially Escherichia coli are the most prevalent pathogen in urinary tract infections,and strains are highly resistant to most antibacterial agents,suggesting that antimicrobial resistance monitoring system is needed.
