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目的分析本地区泌尿系感染病原菌的菌群分布和耐药情况,为临床合理用药提供依据。方法收集2008年1月-2009年9月在本中心皮肤性病门诊、县人民医院门诊和住院的泌尿系感染患者中段尿标本,进行病原菌培养及药物敏感试验。结果分离的328株病原菌中革兰阴性杆菌占66.8%,在革兰阴性杆菌中以大肠埃希菌居首位占49.1%,其次为念珠菌属(13.7%)、肠球菌属(11.3%)、克雷伯菌属(7.6%)、葡萄球菌属(6.0%)。药敏结果显示,大肠埃希菌对亚胺培南最敏感(耐药率为0.6%),对头孢哌酮/舒巴坦、呋喃妥因、阿米卡星等较为敏感,对青霉素类、头孢抗生素以及喹诺酮类等耐药率较高;葡萄球菌属细菌对万古霉素最敏感(耐药率为0%),对呋喃妥因、亚胺培南等较为敏感,对青霉素类、克林霉素及一、二代头孢菌素等耐药率高;肠球菌对万古霉素、呋喃妥因的敏感率高;念珠菌对益康唑、酮康唑、两性霉素B最敏感,对氟康唑、伊康唑等耐药率较高。结论泌尿系感染以革兰阴性杆菌为主,念珠菌属感染也不容忽视,分离株耐药现象比较普遍,提示临床对泌尿系感染患者应根据药敏试验结果使用抗菌药物,减少细菌耐药性的产生,预防二重感染,从而提高疗效。
Objective To analyze the flora distribution and drug resistance of pathogenic bacteria of urinary tract infection in this area and provide basis for clinical rational drug use. Methods From January 2008 to September 2009, urinary specimens from patients with urinary tract infection in the dermatology clinic, county people’s hospital outpatient department and inpatient department were collected for pathogen culture and drug sensitivity test. Results Among the 328 pathogenic bacteria isolated, Gram-negative bacilli accounted for 66.8%, Escherichia coli accounted for 49.1% of Gram-negative bacilli, followed by Candida (13.7%), Enterococcus (11.3%), , Klebsiella (7.6%), Staphylococcus (6.0%). The results of drug susceptibility showed that Escherichia coli was the most sensitive to imipenem (resistance rate was 0.6%), more sensitive to cefoperazone / sulbactam, nitrofurantoin and amikacin. To penicillins, cephalosporin antibiotics As well as quinolones. Staphylococcus bacteria were the most sensitive to vancomycin (resistance rate was 0%), were more sensitive to nitrofurantoin, imipenem and other penicillins, clindamycin and a , Second-generation cephalosporins and other high resistance rates; Enterococcus high rates of vancomycin, nitrofurantoin; Candida most sensitive to econazole, ketoconazole, amphotericin B, fluconazole, Azoles and other drug resistance rates higher. Conclusions Gram-negative bacilli are the main urinary tract infections and Candida infections should not be neglected. Drug-resistant isolates are common, suggesting that clinical use should be based on antimicrobial susceptibility testing to reduce bacterial resistance Produce, prevent double infection, thus improve curative effect.