中国感染控制杂志
中國感染控製雜誌
중국감염공제잡지
Chinese Journal of Infection Control
2015年
9期
611-613,625
,共4页
韩广营%单可记%陈松婷%尹建吉%茆尤尤%熊辛
韓廣營%單可記%陳鬆婷%尹建吉%茆尤尤%熊辛
한엄영%단가기%진송정%윤건길%묘우우%웅신
泌尿系统感染%医院感染%社区感染%病原菌%抗药性,微生物
泌尿繫統感染%醫院感染%社區感染%病原菌%抗藥性,微生物
비뇨계통감염%의원감염%사구감염%병원균%항약성,미생물
urinary system infection%healthcare-associated infection%community-associated infection%pathogen%drug resistance,microbial
目的：分析社区获得性和医院获得性泌尿道感染病原菌构成和耐药性差异。方法回顾性调查2013年1月—2014年6月某院960例泌尿道感染住院患者的临床资料和尿标本微生物送检信息，分析其感染病原菌构成和耐药性差异。结果社区感染403例，医院感染557例；社区获得性和医院获得性泌尿道感染病原菌均以革兰阴性菌（G-）为主，分别占78．16％和66．97％。社区获得性和医院获得性泌尿道感染病原菌构成比较，差异有统计学意义（χ2＝21．68，P ＜0．001）。社区感染与医院感染大肠埃希菌耐药率比较：哌拉西林／他唑巴坦、头孢唑林、头孢哌酮／舒巴坦、氨曲南、美罗培南、厄他培南、庆大霉素、复方磺胺甲口恶唑耐药率差异均有统计学意义（均 P＜0．05）；除氨曲南外，大肠埃希菌对上述抗菌药物的耐药率医院感染均高于社区感染。医院感染屎肠球菌对青霉素、氨苄西林、庆大霉素、左氧氟沙星、环丙沙星、莫西沙星的耐药率均高于社区感染的屎肠球菌，差异均有统计学意义（均 P ＜0．05）。结论社区获得性和医院获得性泌尿道感染病原菌构成和耐药率方面存在一定差异，应结合病原菌构成特点和耐药菌的变化规律，选择适宜的治疗药物，防止和减少耐药菌产生，提高临床治疗效果。
目的：分析社區穫得性和醫院穫得性泌尿道感染病原菌構成和耐藥性差異。方法迴顧性調查2013年1月—2014年6月某院960例泌尿道感染住院患者的臨床資料和尿標本微生物送檢信息，分析其感染病原菌構成和耐藥性差異。結果社區感染403例，醫院感染557例；社區穫得性和醫院穫得性泌尿道感染病原菌均以革蘭陰性菌（G-）為主，分彆佔78．16％和66．97％。社區穫得性和醫院穫得性泌尿道感染病原菌構成比較，差異有統計學意義（χ2＝21．68，P ＜0．001）。社區感染與醫院感染大腸埃希菌耐藥率比較：哌拉西林／他唑巴坦、頭孢唑林、頭孢哌酮／舒巴坦、氨麯南、美囉培南、阨他培南、慶大黴素、複方磺胺甲口噁唑耐藥率差異均有統計學意義（均 P＜0．05）；除氨麯南外，大腸埃希菌對上述抗菌藥物的耐藥率醫院感染均高于社區感染。醫院感染屎腸毬菌對青黴素、氨芐西林、慶大黴素、左氧氟沙星、環丙沙星、莫西沙星的耐藥率均高于社區感染的屎腸毬菌，差異均有統計學意義（均 P ＜0．05）。結論社區穫得性和醫院穫得性泌尿道感染病原菌構成和耐藥率方麵存在一定差異，應結閤病原菌構成特點和耐藥菌的變化規律，選擇適宜的治療藥物，防止和減少耐藥菌產生，提高臨床治療效果。
목적：분석사구획득성화의원획득성비뇨도감염병원균구성화내약성차이。방법회고성조사2013년1월—2014년6월모원960례비뇨도감염주원환자적림상자료화뇨표본미생물송검신식，분석기감염병원균구성화내약성차이。결과사구감염403례，의원감염557례；사구획득성화의원획득성비뇨도감염병원균균이혁란음성균（G-）위주，분별점78．16％화66．97％。사구획득성화의원획득성비뇨도감염병원균구성비교，차이유통계학의의（χ2＝21．68，P ＜0．001）。사구감염여의원감염대장애희균내약솔비교：고랍서림／타서파탄、두포서림、두포고동／서파탄、안곡남、미라배남、액타배남、경대매소、복방광알갑구악서내약솔차이균유통계학의의（균 P＜0．05）；제안곡남외，대장애희균대상술항균약물적내약솔의원감염균고우사구감염。의원감염시장구균대청매소、안변서림、경대매소、좌양불사성、배병사성、막서사성적내약솔균고우사구감염적시장구균，차이균유통계학의의（균 P ＜0．05）。결론사구획득성화의원획득성비뇨도감염병원균구성화내약솔방면존재일정차이，응결합병원균구성특점화내약균적변화규률，선택괄의적치료약물，방지화감소내약균산생，제고림상치료효과。
Objective To analyze the difference in constituent and antimicrobial resistance of pathogens in commu-nity-associated urinary tract infection(CA-UTI)and healthcare-associated UTI(HA-UTI).Methods Clinical data and microbial detection of urine specimens of 960 patients with UTI in a hospital between January 2013 and June 2014 were investigated retrospectively,difference in constituent and antimicrobial resistance of pathogens were ana-lyzed.Results 403 cases were CA-UTI,and 557 were HA-UTI;pathogens in both CA-UTI and HA-UTI were gram-negative bacteria,accounting for 78.16% and 66.97% respectively.Constituent of pathogens in CA-UTI and HA-UTI were significantly different(χ2 =21 .68,P <0.001 ).Resistant rates of Escherichia coli to piperacillin /tazobactam,cefazolin,cefoperazone / sulbactam,aztreonam,meropenem,ertapenem,gentamicin,and compound sulfamethoxazole were all significantly different between CA-UTI and HA-UTI (all P <0.05);Except aztreonam, resistant rates of Escherichia coli in HA-UTI to the other antimicrobial agents were all higher than CA-UTI.Re-sistant rates of Enterococcus faecium in HA-UTI to penicillin,ampicillin,gentamicin,levofloxacin,ciprofloxacin, and moxifloxacin were all higher than CA-UTI(all P <0.05).Conclusion Constituent and antimicrobial resistance of pathogens in CA-UTI and HA-UTI are different,proper antimicrobial agents should be chosen according to con-stituent features of pathogens and change in antimicrobial resistance,so as to prevent and reduce the emergence of drug-resistant strains,and improve therapeutic effectiveness.
