摘要
目的：探讨妇产科患者手术后尿路感染病原菌的种类分布及耐药性,为临床医师诊治尿路感染提供正确诊断与合理用药的参考指南。方法：对177例住院患者的原始病历资料进行逐份查阅统计;感染尿液的留取运送、定量培养、菌落计数、种型鉴定严格按照临床微生物检验的技术路线进行操作;药敏检测采用WHO规定的KB法,抑菌圈测量,敏感、中介、耐药数据的判读遵照CLSI最新规则分析;数据资料采用WHONET 5.6软件作统计学处理,实验条件严格遵照室内质量控制标准管理。结果：177株尿路感染病原菌以肠道菌检出数量最多,共144株,占总株数的81.4%,检出率最高的是大肠埃希菌91株,占总株数的51.4%。部分病原菌对常用抗菌药物产生了较强的抗药性,产ESBLs细菌阳性检出率为46.8%。变形杆菌属细菌耐药率较低;3种革兰阴性杆菌对氨苄西林耐药率最高,达到66.7%-88.9%;其次是磺胺甲噁唑/甲氧苄啶,耐药率均〉60%。但革兰阳性球菌对糖肽类药物、革兰阴性杆菌对碳青霉烯类药物仍然表现100%敏感。结论：妇产科手术患者尿路感染病原菌与其他原因引起的尿路感染病原菌种类差异不大,但耐药性有上升趋势,应努力执行卫生部《抗菌药物临床应用管理办法》,以扭转国内细菌耐药性急剧增长的不良倾向。
Objective：To investigate the species and antimicrobial resistance of pathogenic bacteria causing urinary tract infection after cesarean section in our hospital and provide the reference for correct diagnosis and reasonable use of antibiotics. Method：Original medical records for 177 patients were conducted inspection statistics. Gae- terial culture, counting and identification were performed by the routine methods. K-B method was used as drug sensitive test which was recommended by WHO. Diameter of inhibitor zones was assessed as susceptibility, intermediate and resistant according to the newest CLSI breakpoints. The WHONET 5.6 software was used to adopt the data. Experimental conditions were in strict compliance with internal quality control standards management. Result：144 intestinal bacteria （81.4%） predominated in 177 pathogenic bacteria causing urinary tract infection. The most was Escherichia coli （91 isolates, 51.4%）. Some pathogens had stronger resistance to commonly used antimicrobial agents. Detection rate of ESBLs-producing strains was 46.8 %. Proteus possessed the lower rates of resistance. 3 kinds of gram negative bacilli resistant rate to ampicillin, up to 66.7%-88.9 %, and sulfamethoxazole/trimethoprim with more than 60% of resistance rate. 100% of gram-positive coccus maintained sensitivity to glycopeptide antibiotics. 100 % of gram-negative bacilli kept sensitivity against carbapenems antibiotics. Conclusion：There was not distinctly difference of species between pathogenic bacteria causing urinary tract infection after cesarean section and those causing common urinary tract infection. The antimicrobial resistance was increasing. Management of clinical application of antibiotics should be executed strictly to change harmful situation of increasing antimicrobial resistance.
出处
《临床血液学杂志（输血与检验）》
CAS
2014年第4期668-670,共3页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
关键词
妇产科
手术患者
尿路感染
病原菌
细菌种型
抗药性
department of gynecology and obstetrics
surgery patients
urinary tract infection
pathogenic bacteria
species~ resistance
