966株尿路感染病原菌的分布

目的分析尿路感染的病原菌分布及耐药性特点，为临床选用抗菌药物提供依据。方法采用VITEK-32细菌鉴定仪鉴定菌种，对尿路感染患者的1978份尿液标本中分离的966株泌尿系感染病原菌进行鉴定及药物敏感试验。结果在分离的966株病原菌中，革兰阴性菌675株（占69．9％），主要为大肠埃希菌；革兰阳性菌183株（占18．9％），主要为粪肠球菌；真菌108株（占11．2％），主要为白色念珠菌。分离数在前5位的病原菌依次为大肠埃希菌（占49．0％）、粪肠球菌（占9．6％）、肺炎克雷伯菌（占7．ooA）、白色念珠菌（占6．8％）、奇异变形杆菌（占3．9％）。大肠埃希菌产超广谱争内酰胺酶（ESBLs）检出率为47．3％，肺炎克雷伯菌产ESBLs检出率为33．8％。甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出率为44．8％，耐甲氧西林金黄色葡萄球菌（MRSA）的检出率为50％。结论引起尿路感染病原菌的分布广泛，大肠埃希菌为尿路感染的主要病原菌。有些菌株产生多重耐药性，大肠埃希菌产ESBLs检出率较高。应尽量根据药物敏感试验选用抗菌药物，减少耐药菌株的产生和医院感染的爆发流行。

Distribution of 966 strains of pathogens in urinary system infection

Objective To analyze the distribution of pathogens and their drug resistance in urinary system infection,and to provide the information for choosing suitable antibiotic. Methods Totally 966 strains of pathogenic bacteria were isolated from clinical urine samples in urinary system infection. The bacteria were identified by the automated analyzer VITEK-32 made by Bio-M rieux Company in France and the drug resist- ance was analyzed with the K-B test. Results In the 966 strains of pathogens,69. 9% were Gram-negative, 18. 9% were Gram-positive,and 11.2% were fungi. Most of Gram-negative bacteria were Escherichia coil, most of Gram-positive bacteria were Enterococcus faecalis,and most of fungi were candida albicans. Separa- tions of the first five bacteria were Escherichia coli （49. 0 %）, Enterococcus faecalis （9. 6 % ）, Klebsiella pneu- moniae （7. 0%） ,Candida alhicans （6. 8%） ,and Proteus mirabilis （3. 9%）. About 47. 3% of the Escherichia coli isolates and 33. 8% of the Klebsiella pneumoniae isolates produced ESBLs. The prevalence of methicillin- resistant coagulase-negative Staphylococcus（MRCNS） was 44. 8%. The prevalence of MRSA was 50. 0%. Conclusions The pathogens of causing urinary tract infection are widely distributed, and Escherichia coli are the major pathogens of urinary tract infection in the region. Some of them are multiple drugs resistant,and the detection rate of ESBLs produced by Escherichia coli was high. So clinicians should choose antibiotics rational with the drug sensitivity test to reduce drug-resistant strains and an outbreak of hospital infection.