中国执业药师
中國執業藥師
중국집업약사
CHINA LICENSED PHARMACIST
2015年
6期
11-16
,共6页
泌尿系感染%病原菌%耐药性
泌尿繫感染%病原菌%耐藥性
비뇨계감염%병원균%내약성
Urinary Tract Infection%Pathogen%Drug Resistance
目的：对河北联合大学附属医院2014年1-12月泌尿系感染患者病原菌分布及耐药性进行分析，为临床治疗泌尿系感染提供依据。方法：收集2014年1-12月尿培养分离出的泌尿系感染的病原菌，菌株鉴定采用美国BD公司的Phoenix-100全自动细菌分析仪，药敏试验采用MIC法和K-B纸片法。结果：1108份标本中共分离泌尿系感染纯致病菌216株；其中革兰阴性菌121株，以大肠埃希菌（72株，33.3%）为主，革兰阳性菌51株，主要为粪肠球菌（32株，14.8%），真菌44株，主要为白色念珠菌（22株，10.2%）；这些病原菌主要分离自泌尿外科（65株，30.1%）；216例泌尿系感染住院患者中男性构成比（63.0%）大于女性构成比（37.0%）。大肠埃希菌对氨苄西林、阿莫西林-克拉维酸、左氧氟沙星、庆大霉素耐药率比较高，分别为98.5%，75.3%，79.4%，70.6%；对亚胺培南、美罗培南、阿米卡星、哌拉西林-他唑巴坦、头孢哌酮-舒巴坦耐药率分别为6.9%，6.9%，11.8%，15.3%，11.1%，比较敏感；粪肠球菌和屎肠球菌对青霉素和左氧氟沙星耐药率较高，分别为84.4%，56.2%和88.9%，75.0%，对万古霉素、替考拉宁、利奈唑胺均较敏感，但是出现1例耐万古霉素的屎肠球菌；真菌中白色念珠菌对临床常用的抗真菌药物都保持着较高的敏感性，热带念珠菌对氟康唑耐药率为33.3%，对5-氟胞嘧啶、伏立康唑、两性霉素B、伊曲康唑比较敏感。结论：泌尿系感染的病原菌分布及耐药都各具特点，临床医生应经常关注其分布和耐药特点的变化，并根据药敏试验结果合理选择抗菌药。
目的：對河北聯閤大學附屬醫院2014年1-12月泌尿繫感染患者病原菌分佈及耐藥性進行分析，為臨床治療泌尿繫感染提供依據。方法：收集2014年1-12月尿培養分離齣的泌尿繫感染的病原菌，菌株鑒定採用美國BD公司的Phoenix-100全自動細菌分析儀，藥敏試驗採用MIC法和K-B紙片法。結果：1108份標本中共分離泌尿繫感染純緻病菌216株；其中革蘭陰性菌121株，以大腸埃希菌（72株，33.3%）為主，革蘭暘性菌51株，主要為糞腸毬菌（32株，14.8%），真菌44株，主要為白色唸珠菌（22株，10.2%）；這些病原菌主要分離自泌尿外科（65株，30.1%）；216例泌尿繫感染住院患者中男性構成比（63.0%）大于女性構成比（37.0%）。大腸埃希菌對氨芐西林、阿莫西林-剋拉維痠、左氧氟沙星、慶大黴素耐藥率比較高，分彆為98.5%，75.3%，79.4%，70.6%；對亞胺培南、美囉培南、阿米卡星、哌拉西林-他唑巴坦、頭孢哌酮-舒巴坦耐藥率分彆為6.9%，6.9%，11.8%，15.3%，11.1%，比較敏感；糞腸毬菌和屎腸毬菌對青黴素和左氧氟沙星耐藥率較高，分彆為84.4%，56.2%和88.9%，75.0%，對萬古黴素、替攷拉寧、利奈唑胺均較敏感，但是齣現1例耐萬古黴素的屎腸毬菌；真菌中白色唸珠菌對臨床常用的抗真菌藥物都保持著較高的敏感性，熱帶唸珠菌對氟康唑耐藥率為33.3%，對5-氟胞嘧啶、伏立康唑、兩性黴素B、伊麯康唑比較敏感。結論：泌尿繫感染的病原菌分佈及耐藥都各具特點，臨床醫生應經常關註其分佈和耐藥特點的變化，併根據藥敏試驗結果閤理選擇抗菌藥。
목적：대하북연합대학부속의원2014년1-12월비뇨계감염환자병원균분포급내약성진행분석，위림상치료비뇨계감염제공의거。방법：수집2014년1-12월뇨배양분리출적비뇨계감염적병원균，균주감정채용미국BD공사적Phoenix-100전자동세균분석의，약민시험채용MIC법화K-B지편법。결과：1108빈표본중공분리비뇨계감염순치병균216주；기중혁란음성균121주，이대장애희균（72주，33.3%）위주，혁란양성균51주，주요위분장구균（32주，14.8%），진균44주，주요위백색념주균（22주，10.2%）；저사병원균주요분리자비뇨외과（65주，30.1%）；216례비뇨계감염주원환자중남성구성비（63.0%）대우녀성구성비（37.0%）。대장애희균대안변서림、아막서림-극랍유산、좌양불사성、경대매소내약솔비교고，분별위98.5%，75.3%，79.4%，70.6%；대아알배남、미라배남、아미잡성、고랍서림-타서파탄、두포고동-서파탄내약솔분별위6.9%，6.9%，11.8%，15.3%，11.1%，비교민감；분장구균화시장구균대청매소화좌양불사성내약솔교고，분별위84.4%，56.2%화88.9%，75.0%，대만고매소、체고랍저、리내서알균교민감，단시출현1례내만고매소적시장구균；진균중백색념주균대림상상용적항진균약물도보지착교고적민감성，열대념주균대불강서내약솔위33.3%，대5-불포밀정、복립강서、량성매소B、이곡강서비교민감。결론：비뇨계감염적병원균분포급내약도각구특점，림상의생응경상관주기분포화내약특점적변화，병근거약민시험결과합리선택항균약。
ABSTRACTObjective:To analyze the pathogen distribution and drug resistance of the patients with urinary tract infection in the affiliated hospital of Hebei United University from January to December 2014, so as to provide an evidence for clinical treatment of urinary tract infections.Methods:Pathogenic bacteria isolated by urine culture of the samples of urinary tract infections were collected and the strains were identified using BD Phoenix-100 automat-ic bacterial analyzer. The drug sensitivity test was carried out by MIC method and K-B method.Results:Out of 1 108 specimens, 216 strains of pathogenic bacteria of urinary tract infection were isolated. About 121 strains were gram-negative bacteria, most of which wereEscherichiacoli(72 strains, 33.3%), 51 strains were gram-positive bacteria, most of which wereEnterococcusfaecalis(32 strains, 14.8%)and 44 strains were fungi with the major strains ofCandidaalbicans(22 strains, 10.2%). The pathogenic bacteria were mainly isolated from samples of urology department(65 strains, 30.1%). In 216 cases, the composition of male patients(63.0%)was higher thanthat of female patients(37.0%).Escherichiacolishowed more resistance to ampicillin, amoxicillin-clavulanic acid, levofloxacin, and gentamicin, with the resistance rate of 98.5%, 75.3%, 79.4% and 70.6% respectively.Escherichia coliwas less resistant to imipenem, meropenem, amikacin, piperacillin-tazobactam and cefoperazone-sulbactam, with resistance rate of 6.9%, 6.9%, 11.8%, 15.3% and 11.1% respectively.EnterococcusfaecalisandE.faeciumwere more resistant to penicillin and levofloxacin, with resistant rate of 84.4%, 56.2% and 88.9%, 75.0% respectively. EnterococcusfaecalisandE.faeciumwas sensitive to vancomycin, linezolid and teicoplanin, but there was one case ofEnterococcusfaeciumresistant to vancomycin.Candidaalbicansfungi had a high sensitivity to common antifungal drugs. Resistance rate oftropicalcandidato fluconazole was 33.3%.Tropicalcandidawas sensitive to 5-flucytosine, voriconazole,amphotericin B and itraconazole.Conclusion:Pathogenic bacteria distribution and drug resistance patterns of urinary tract infection have their own characteristics. Therefore clinicians should focus on the changes of characteristics of distribution and drug resistance, and choose appropriate antibacterial agents according to the results of drug sensitivity test.
