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目的:调查本地区近3年来尿路感染致病菌分布情况,同时监测其耐药性,为临床用药提供参考。方法:用纸片扩散法进行抗生素敏感试验,双纸片协同筛选试验和纸片扩散法表型确证试验检测超广谱β内酰胺酶(ESBLs)。结果:尿培养阳性的399份尿标本中,分离出革兰阴性杆菌241株,占60.40%,革兰阳性球菌158株,占39.60%,致病菌所占比例为:大肠埃希菌45.61%、葡萄球菌17.04%、粪肠球菌10.78%、链球菌9.27%、克雷伯菌5.76%、变形杆菌2.76%、屎肠球菌2.51%、铜绿假单孢菌1.75%、不动杆菌1.25%、棒状杆菌0.75%、沙雷氏菌0.50%、阴沟肠杆菌0.50%、其他1.50%。产ESBLs菌73株,占革兰阴性杆菌尿路感染30.29%。革兰阴性杆菌对氨苄青霉素、环丙沙星、磺胺、庆大霉素的耐药率分别为86.84%、55.90%、70.61%、45.85%。革兰阳性球菌对青霉素、红霉素、克林霉素、环丙沙星、磺胺的耐药率为50.35%～88.46%。结论:本地区尿路感染的主要致病菌仍以革兰阴性杆菌为主,但革兰阳性球菌的比例明显升高,产ESBLs菌株的流行情况相当严重。细菌对临床常用抗生素的耐药率较高。
OBJECTIVE: To investigate the distribution of pathogenic bacteria in urinary tract infection in the past three years in our region and to monitor its drug resistance for reference. Methods: ESBLs were detected by disk diffusion method, antibiotic susceptibility test, synergistic screening test with two sheets of paper and phenotype confirmation test with disk diffusion method. Results: Of the 399 urine samples positive for urine culture, 241 strains of Gram-negative bacilli were isolated, accounting for 60.40%, 158 strains of Gram-positive cocci, accounting for 39.60%, and the proportion of pathogenic bacteria was 45.61% , Staphylococcus aureus 17.04%, Enterococcus faecalis 10.78%, Streptococcus 9.27%, Klebsiella 5.76%, Proteus 2.76%, Enterococcus faecium 2.51%, Pseudomonas aeruginosa 1.75%, Acinetobacter 1.25% 0.75% of bacilli, 0.50% of Serratia, 0.50% of Enterobacter cloacae, and 1.50% of others. 73 strains of ESBLs-producing bacteria, accounting for 30.29% of gram-negative bacilli in urinary tract infection. The resistance rates of Gram-negative bacilli to ampicillin, ciprofloxacin, sulfanilamide and gentamycin were 86.84%, 55.90%, 70.61% and 45.85%, respectively. Gram-positive cocci penicillin, erythromycin, clindamycin, ciprofloxacin, sulfa resistance rate of 50.35% to 88.46%. Conclusion: The main pathogens of urinary tract infection in this area are still Gram-negative bacilli, but the proportion of Gram-positive cocci is obviously increased. The prevalence of ESBLs-producing strains is quite serious. Bacteria commonly used in clinical antibiotics resistant rate is higher.