摘要
目的:调查老年尿液病原菌分布及其耐药情况,为选用抗菌药物控制泌尿系统感染(USI)提供依据。方法:收集我院2018年9月至2020年9月住院的1465例老年USI患者送检中段尿液标本,通过西门子SCAN4全自动细菌鉴定及药敏分析系统配套的鉴定卡、药敏卡,进行的病原菌鉴定以及分离出的可疑菌落药物敏感性试验,对病原菌分布特点和耐药情况进行分析。结果:共分离出357株病原菌,阳性检出率为24.37%。分离病原菌中G-杆菌231株、G+球菌115株、念珠菌11株,分别占比为64.71%、32.21%、3.08%。检出病原菌中以大肠埃希菌(占32.77%)、屎肠球菌(占20.45%)、铜绿假单胞菌(占13.73%)、肺炎克雷伯菌(占8.68%)和粪肠球菌(占7.56%)为常见。大肠埃希菌对头孢类、庆大霉素、氨苄西林、氨苄西林/舒巴坦、左氧氟沙星的耐药率均在50.00%以上,铜绿假单胞菌和肺炎克雷伯菌(除对阿米卡星和氨曲南耐药率<25.0%外)对大多数抗菌药物的耐药率均在45.0%以上,对氨苄西林100.0%耐药。屎肠球菌对红霉素100.0%耐药,对大多数抗菌药物的耐药率均在45.0%以上,粪肠球菌对大多数抗菌药物的耐药率均在25.0%以上。未发现亚胺培南对E.coli、阿米卡星对PA、亚胺培南和左氧氟沙星对KP、利奈唑胺对屎肠球菌和万古霉素和利奈唑胺对粪肠球菌的耐药菌株。仅检出1株万古霉素对屎肠球菌耐药,耐药率为1.37%。结论:我院住院老年USI患者的病原菌构成复杂、种类多,且对常用抗菌药物具有较为严重耐药性。临床应重视本地区老年USI患者的病原菌分布特点以及具体耐药情况,对合理选用抗菌药物以及有针对性采取预防措施有重要意义。
Objective By investigating the distribution of urine pathogens and their drug resistance in the elderly,it provides the basis for selecting antibiotics to control urinary system infection(USI).Methods The urine samples of 1465 elderly USI patients admitted in our hospital from September 2018 to September 2020 were collected for examination.The distribution characteristics and drug resistance of pathogenic bacteria were analyzed by Siemens SCAN4 automatic bacterial identification and drug sensitivity analysis system matching identification card,drug sensitivity card,pathogen identification and isolated suspicious colony drug sensitivity test.Results A total of 357 pathogenic bacteria were isolated,and the positive rate was 24.37%.There were 231 strains of G-bacteria,115 strains of G cocci and 11 strains of Candida,accounting for 64.71%,32.21% and 3.08%,among the pathogenic bacteria detected were Escherichia coli(32.77%),enterococci(20.45%),Pseudomonas aeruginosa(13.7%),Feiyankeleibojun(8.68%)and faecal cocci(7.56%)are common.The resistance rates of Escherichia coli to cephalosporins,gentamicin,ampicillin/sulbactam and levofloxacin were all above 50.00%.Pseudomonas aeruginosa and Klebsiella pneumoniae(Except for amikacin and aztreonam,the drug resistance rate is less than 25.0%.)were more than 45.0% and 100.0% resistant to ampicillin.The resistance rate of Enterococcus faecium to erythromycin was 100.0%.The resistance rate of Enterococcus faecium to most antibiotics was above 45.0%.The resistance rate of Enterococcus faecium to most antibiotics was above 25.0%.There were no resistance strains of imipenem against E.coli,amikacin to PA,imipenem and levofloxacin against KP,linezolazolamine against Enterococcus faecal and Vancomycin and Linezolazolamine against Enterococcus.Only one strain of vancomycin was resistant to Enterococcus faecium,and the resistance rate was 1.37%.Conclusion Among the elderly USI patients in our hospital,the pathogen composition is complex,variety is many,and serious resistance to common antimicrobial agents.Clinical attention should be paid to the distribution of pathogenic bacteria and specific drug resistance of elderly USI patients in this area,which is of great significance for rational selection of antimicrobial agents and targeted preventive measures.
作者
陈玲
杨传松
肖金
Chen Ling;Yang Chuansong;Xiao Jin(The Laboratory Medicine of the People's hospital of Jiangyou,Sichuan,jiangyou 621700,China)
出处
《现代科学仪器》
2021年第2期104-108,共5页
Modern Scientific Instruments
关键词
泌尿系统感染
尿液培养
可疑菌落
药物敏感试验
Urinary system infection
urine culture
Suspicious colony
drug sensitivity test
