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目的了解尿培养病原菌分布及耐药性,为临床经验性治疗尿路感染提供参考。方法对2011年1月~2015年12月尿培养病原菌进行细菌鉴定及药敏分析,用WHONET 5.4软件进行统计分析。结果 53 584份标本检测出病原菌10 690株,阳性率为19.95%;分离率前5位依次是大肠埃希菌、屎肠球菌、白色念珠菌、粪肠球菌及肺炎克雷伯菌,分别占36.00%、8.92%、7.56%、6.42%和6.17%。大肠埃希菌和肺炎克雷伯菌对亚胺培南耐药率分别为0.39%和4.00%,对头孢吡肟、头孢他啶、妥布霉素、氨曲南及哌拉西林/他唑巴坦耐药率为1.61%~21.39%,但对头孢呋辛和氨苄西林耐药率>70.00%。铜绿假单胞菌对阿米卡星、庆大霉素、妥布霉素、头孢吡肟、哌拉西林/他唑巴坦、亚胺培南、左氧氟沙星和环丙沙星耐药率<14.00%。屎肠球菌对万古霉素、利奈唑胺耐药率分别为2.46%、4.80%,粪肠球菌对多数抗菌药物耐药率明显低于屎肠球菌。结论肠杆菌属、肠球菌属和白色念珠菌是尿培养主要病原菌,其中肠球菌属对利奈唑胺耐药率高于万古霉素,且已出现耐碳青酶烯类的肠杆菌。
Objective To understand the distribution and drug resistance of pathogenic bacteria in urine culture and provide reference for the clinical treatment of urinary tract infection. Methods Bacteria identification and drug susceptibility analysis of urinary culture pathogen from January 2011 to December 2015 were carried out. The data were analyzed by WHONET 5.4 software. Results A total of 10690 strains of pathogens were detected in 53 584 samples, the positive rate was 19.95%. The top 5 isolates were Escherichia coli, Enterococcus faecium, Candida albicans, Enterococcus faecalis and Klebsiella pneumoniae, respectively 36.00%, 8.92%, 7.56%, 6.42% and 6.17%. The resistant rates of Escherichia coli and Klebsiella pneumoniae to imipenem were 0.39% and 4.00%, respectively. The rates of resistance to cefepime, ceftazidime, tobramycin, aztreonam and piperacillin / tazobactam The rate of resistance was 1.61% ~ 21.39%, but the rate of resistance to cefuroxime and ampicillin was> 70.00%. Resistance rate of Pseudomonas aeruginosa to amikacin, gentamycin, tobramycin, cefepime, piperacillin / tazobactam, imipenem, levofloxacin and ciprofloxacin <14.00 %. Enterococcus faecium vancomycin, linezolid resistance rates were 2.46%, 4.80%, Enterococcus faecalis most of the antibacterial drug resistance rate was significantly lower than that of Enterococcus faecium. Conclusion Enterobacter, Enterococcus and Candida albicans are the main pathogens in urinary culture. Enterococcus faecalis is more resistant to linezolid than vancomycin, and enterococci resistant to carbapenem have been found.