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目的了解微创泌尿外科患者感染病原菌分布及耐药性情况,为控制临床感染提供科学指导。方法收集1 155份泌尿外科住院患者送检标本,分离病原菌,剔除相同患者的重复菌株。用API鉴定系统进行送检样本的菌种鉴定,纸片扩散法进行药敏实验。结果共分离出病原菌418株,其中革兰阴性菌271株(占64.83%),革兰阳性菌108株(占25.84%),真菌39株(占9.33%)。革兰阴性菌主要有大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌,分别为142、44和33株;革兰阳性菌主要有粪肠球菌和屎肠球菌,分别为37和21株;真菌主要为白色假丝酵母菌,共17株。革兰阴性菌对青霉素G、左氧氟沙星、庆大霉素、环丙沙星、头孢曲松、哌拉西林、头孢他啶、阿米卡星、氨曲南、呋喃妥因的耐药率分别为60.89%、53.87%、38.75%、34.69%、31.73%、29.89%、24.72%、21.77%、13.65%和7.75%;革兰阳性菌对青霉素G、左氧氟沙星、环丙沙星、头孢呋辛、头孢噻肟、阿奇霉素、阿米卡星、头孢他啶、妥布霉素、氨苄西林的耐药率分别为65.74%、50.00%、46.30%、41.67%、37.96%、35.19%、28.70%、21.30%、17.59%和10.19%。真菌对氟胞嘧啶仍然敏感,但对氟康唑、伏立康唑、伊曲康唑的耐药率分别为17.95%、23.08%、46.15%。结论微创泌尿外科患者感染病原菌以革兰阴性菌为主,各菌对常用抗菌药物均产生了不同程度的耐药性,真菌仍对氟胞嘧啶敏感。
Objective To understand the distribution and drug resistance of pathogenic bacteria in minimally invasive urological patients and provide scientific guidance for controlling clinical infection. Methods A total of 1 155 urological inpatients were collected and pathogenic bacteria were isolated, and repeated strains of the same patients were excluded. API identification system for submission of samples of species identification, disk diffusion method for susceptibility testing. Results A total of 418 pathogenic bacteria were isolated, of which 271 were Gram-negative bacteria (64.83%), 108 were Gram-positive bacteria (25.84%) and 39 were fungi (9.33%). Gram-negative bacteria are Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa, respectively, 142,44 and 33 strains; Gram-positive bacteria are Enterococcus faecalis and Enterococcus faecium, respectively 37 and 21 strains; fungi mainly Candida albicans, a total of 17 strains. The resistance rates of Gram-negative bacteria to penicillin G, levofloxacin, gentamicin, ciprofloxacin, ceftriaxone, piperacillin, ceftazidime, amikacin, aztreonam and nitrofurantoin were 60.89% and 53.87 Gram positive bacteria against penicillin G, levofloxacin, ciprofloxacin, cefuroxime, cefotaxime, azithromycin , Amikacin, ceftazidime, tobramycin and ampicillin were 65.74%, 50.00%, 46.30%, 41.67%, 37.96%, 35.19%, 28.70%, 21.30%, 17.59% and 10.19% . The fungi were still sensitive to flucytosine, but the resistance rates to fluconazole, voriconazole and itraconazole were 17.95%, 23.08% and 46.15% respectively. CONCLUSION: Gram-negative bacteria are the main pathogens in patients with minimally invasive urological diseases. All bacteria have different levels of resistance to commonly used antimicrobial agents, and the fungi are still susceptible to flucytosine.