摘要
目的了解肿瘤患者泌尿系感染的病原菌分布及耐药性,为临床治疗泌尿系感染提供参考依据。方法对医院2008年1月-2011年12月肿瘤患者尿标本中分离的病原菌,采用纸片扩散法K-B法进行抗菌药物敏感性试验,以WHONET 5.4软件分析数据。结果 2008-2011年肿瘤住院患者尿标本中分离出病原菌359株,其中大肠埃希菌最多148株占41.2%,其次为肺炎克雷伯菌55株占15.3%,凝固酶阴性葡萄球菌39株占10.9%,肠球菌属细菌31株占8.6%,酵母样真菌24株占6.7%和铜绿假单胞菌19株占5.3%;耐药性分析显示,大肠埃希菌和肺炎克雷伯菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和阿米卡星的耐药率均<20.0%;对呋喃妥因耐药率分别为8.8%和52.8%,对亚胺培南保持高度敏感;铜绿假单胞菌对亚胺培南和阿米卡星较敏感,粪肠球菌对青霉素、氨苄西林和呋喃妥因的耐药率均<20.0%、屎肠球菌的耐药率均>60.0%,凝固酶阴性葡萄球菌对呋喃妥因较敏感;除检出1株耐万古霉素母鸡肠球菌外,未检出糖肽类耐药的革兰阳性球菌。结论革兰阴性杆菌为肿瘤患者泌尿系感染的主要病原菌,临床分离菌株对多数常用抗菌药物耐药率均呈上升趋势,重视病原菌的监测和合理用药具有重要意义。
OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria causing urinary tract infections in tumor patients so as to provide basis for clinical treatment of urinary tract infections. METHODS By means of disk diffusion K-B method, the drug susceptibility testing was performed for the pathogens isolated from the urine specimens from Jan 2008 to Dec 2011, and the data were analyzed by WHONET 5.4 software. RESULTS Totally 359 strains of pathogens were isolated from the urine specimens of the patients who enrolled the hospital during 2008-2011, among which there were 148 （ 41.2% ） strains of Escherichia coli, 55 （15.3%） strains of Klebsiella pneumoniae, 39 （10. 9%） strains of coagulase-negative Staphylococcus, 31 （8.6%） strains of Enterococcus, 24 （6.7%） strains of yeast-like fungi, and 19 （5.3%） strains of Pseudomonas aeruginosa. The drug resistance rates of E. coli and K. pneurnoniae to cefoperazone-sulbactam, piperacillin-tazobactam and amika-cin were less than 20.0%, the drug resistance rates to nitrofurantoin were 8.8% and 52.8%, respectively, and the strains were highly sensitive to imipenem. The P. aeruginosa strains were sensitive to imipenem and amikacin, and the drug resistance rates to penicillin, ampicillin and nitrofurans were less than 20.0%. The resistance rates of E. faecali strains were lower than 20.0%, while the resistance rates of the E. faecium strains were higher than 60.0%. The coagulase-negative Staphylococcus strains were sensitive to nitrofurans. Except one strain of Enterococcus gallinarum naturally resistant to vancomycin, there were no strains of gram-positive cocci resistant to glycopeptide. CONCLUSION The gram-negative bacilli are the major pathogenic bacteria causing urinary tract infections. The drug resistance rates of the clinical isolates to most of the commonly used antibiotics keep an upward trend. It is of great significance to pay attention to the monitoring of pathogens and to reasonably use anti-biotics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第11期2760-2762,共3页
Chinese Journal of Nosocomiology
关键词
泌尿系感染
病原菌
抗菌药物
Urinary tract infection
Pathogenic bacteria
Antibiotics
