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目的对我院近6年泌尿系感染患者中段尿中病原菌分布、耐药性及感染危险因素进行调查,为泌尿系感染防治提供依据。方法大多数分离细菌的鉴定和药敏试验利用BDPhoenix仪,少数利用手工鉴定和K-B法药敏试验。念珠菌利用显色平板分离和鉴定,K-B法药敏试验。数据分析用WHONET5.4软件。结果中段尿中病原菌主要种类为大肠埃希菌、白色念珠菌、肺炎克雷伯菌、粪肠球菌和热带念珠菌。G+球菌万古霉素敏感率为100.0%,其他抗生素耐药率均较高,葡萄球菌属甲氧西林耐药率为68.0%～73.5%。G-杆菌中耐药率较低的为亚胺培南、头孢哌酮/舒巴坦、阿米卡星、哌拉西林/他唑巴坦和头孢他啶,大肠埃希菌和肺炎克雷伯菌产ESBLs比例为30.8%～34.2%和32.7%～34.4%。念珠菌属对两性霉素B和制菌霉素的耐药率均为0.0%。感染危险因素主要包括住院天数>5d、静脉插管、泌尿道插管、手术、吸氧和糖尿病。结论泌尿系感染患者中段尿中念珠菌构成比、大肠埃希菌产ESBLs比例、非发酵G-杆菌碳青霉烯类耐药率、葡萄球菌属甲氧西林耐药率均较高,应加强抗生素合理使用。
Objective To investigate urinary distribution of pathogens, drug resistance and risk factors of infection in the middle of urinary tract infection in the past 6 years in our hospital so as to provide basis for prevention and treatment of urinary tract infection. Methods The majority of isolated bacteria were identified and tested for susceptibility using a BDPhoenix instrument, with a handful of manual assays and K-B susceptibility tests. Candida using color plate separation and identification, K-B method susceptibility testing. WHONET5.4 software for data analysis. Results The main types of urinary pathogens in the middle were Escherichia coli, Candida albicans, Klebsiella pneumoniae, Enterococcus faecalis and Candida tropicalis. The prevalence of vancomycin was 100.0% for G + cocci, while the rates of other antibiotics were high. The rates of methicillin-resistant Staphylococcus were 68.0% -73.5%. The antibiotic resistance rates in G-bacilli were imipenem, cefoperazone / sulbactam, amikacin, piperacillin / tazobactam and ceftazidime, Escherichia coli and Klebsiella pneumoniae ESBLs-producing ratio of 30.8% to 34.2% and 32.7% to 34.4%. The rate of Candida resistance to amphotericin B and ampicillin was 0.0%. Infection risk factors mainly include hospitalization days> 5d, intravenous catheterization, urinary catheterization, surgery, oxygen and diabetes. Conclusions Urine Candida albicans composition ratio, Escherichia coli ESBLs production rate, non-fermentative G-bacilli carbapenem resistance rate and Staphylococcus methicillin resistance rate are higher in the middle urinary tract infection patients and should be strengthened Rational use of antibiotics.