高压氧科医院获得性泌尿系感染病原菌分布及耐药分析
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摘要
目的探讨我中心2014-2018年高压氧科病人泌尿系感染病原菌种类及耐药情况。方法回顾性分析2014-2018年我中心高压氧科泌尿系感染患者尿液标本病原菌种类及耐药数据,样本分离培养后,应用梅里埃全自动微生物分析仪及美国布鲁克MALDI-TOF质谱仪进行菌种鉴定,药敏试验采用最小抑菌浓度法(MIC)。结果5年间我中心高压氧科病人医院获得性泌尿系感染共计309例,分离病原菌362株、25种,以革兰阴性菌为主,占71.82%,革兰阳性菌和真菌分别占17.13%和11.05%。革兰阴性菌中以大肠埃希菌为主,占24.03%,其对呋喃妥因敏感性最好,耐药率仅1.19%;革兰阳性菌以屎肠球菌为主,占8.56%,其对替加环素敏感性最好,未出现相应耐药株;真菌以白色念珠菌居多,占5.52%,对氟胞嘧啶、氟康唑和两性霉素B的耐药率均为0。结论定期关注高压氧科病人泌尿系感染病原菌种类及耐药情况,对于指导临床医生经验性抢先治疗具有重要意义。
Objective To investigate the distribution and antibiotic resistance of pathogens isolated from the patients with urinary tract infections(UTI)in the department of hyperbaric oxygen(HBO)in our hospital from 2014 to 2018.Methods The pathogen species and antibiotic resistance data of the patients with UTI in the department of hyperbaric oxygen from 2014 to 2018 were retrospectively analyzed.All the samples were identified by VITEK 2 Compact of Biomerieux and MALDI-TOF MS of Bruker Daltonics,and the drug susceptibility tests were performed with MIC methods.Results There were 309 UTI cases in the HBO department within 5 years,and totally 362 strains(25 species)were isolated.Gram-negative bacteria,accounted for 71.82% of all the isolates,were the predominant pathogens.The proportions of Gram-positive bacteria and fungi were 17.13% and 11.05%,respectively.Escherichia coli,with the proportion of 24.03%,was the major pathogen among the Gram-negative bacteria and presented the lowest resistance rate to Nitrofurantoin(1.19%).Enterococcus Faecium,with the proportion of 8.56%,was the major pathogen among the Grampositive bacteria and had no resistance to Tigecycline.Candida albicans was the major pathogen among fungi(5.52%)and not resistant to Flucytosine,Fluconazole and Amphotericin B at all.Conclusion It is significant to guide clinicians performing empiric and preemptive therapy by regularly monitoring the distribution and antibiotic resistance of pathogens from the UTI patients in the HBO department.
Objective To investigate the distribution and antibiotic resistance of pathogens isolated from the patients with urinary tract infections(UTI)in the department of hyperbaric oxygen(HBO)in our hospital from 2014 to 2018.Methods The pathogen species and antibiotic resistance data of the patients with UTI in the department of hyperbaric oxygen from 2014 to 2018 were retrospectively analyzed.All the samples were identified by VITEK 2 Compact of Biomerieux and MALDI-TOF MS of Bruker Daltonics,and the drug susceptibility tests were performed with MIC methods.Results There were 309 UTI cases in the HBO department within 5 years,and totally 362 strains(25 species)were isolated.Gram-negative bacteria,accounted for 71.82% of all the isolates,were the predominant pathogens.The proportions of Gram-positive bacteria and fungi were 17.13% and 11.05%,respectively.Escherichia coli,with the proportion of 24.03%,was the major pathogen among the Gram-negative bacteria and presented the lowest resistance rate to Nitrofurantoin(1.19%).Enterococcus Faecium,with the proportion of 8.56%,was the major pathogen among the Grampositive bacteria and had no resistance to Tigecycline.Candida albicans was the major pathogen among fungi(5.52%)and not resistant to Flucytosine,Fluconazole and Amphotericin B at all.Conclusion It is significant to guide clinicians performing empiric and preemptive therapy by regularly monitoring the distribution and antibiotic resistance of pathogens from the UTI patients in the HBO department.
引文
1 Shafer CW,Allison JR,Hogue AL,et al.Infectious Disease:Health Care-Associated Infections[J].FP Essent,2019,476:30-42.
2 Jacobsen SM,Stickler DJ,Mobley HL,et al.Complicated catheter-associated urinary tract infections due to Escherichia coli and Proteus mirabilis[J].Clin Microbiol Rev,2008,21(1):26-59.
3郑奋薇,蔡桂程,梁美莲,等.重症患者导管相关性尿路感染危险因素分析[J].解放军医学院学报,2018,39(6):494-497.
4 Jadoon SA,Ahmed A,Irshad R.Spectrum Of Bacterial Culture And Drug Sensitivity Vs Resistance In Uncomplicated Urinary Tract Infection[J].J Ayub Med Coll Abbottabad,2018,30(3):432-438.
5黄友明,黄欣,邓峥,等.泌尿系感染分离病原菌分布及耐药性分析[J].实验与检验医学,2018,36(6):935-937.
6邓宁宁,教莹莹,刘沛.ICU医院获得性泌尿道感染病原菌及耐药分析[J].中国医药科学,2018,8(19):223-226.
7丁厚文,刘周,吴园园,等.1127株尿培养病原菌分布及耐药性分析[J].国际检验医学杂志,2018,39(4):477-480.
8郭健莲,谢志雄.泌尿系统真菌感染的分布及其耐药性分析[J].国际检验医学杂志,2014,(13):1681-1682.
9 Chiang CH,Pan SC,Yang TS,et al.Healthcare-associated infections in intensive care units in Taiwan,South Korea,and Japan:recent trends based on national surveillance reports[J].Antimicrob Resist Infect Control,2018,7:129.
10元淑巧,班丽素,赵强,等.泌尿系感染患者病原菌分布及药物敏感性分析[J].解放军医学院学报,2015,36(6):599-602.
11严威,靳情.医院内泌尿道感染患者的病原菌耐药性分析[J].医学信息,2018,31(11):118-120.
12钟芳灵,张玉艳,梁雄发,等.真菌性泌尿系感染的菌群分布及药敏分析[J].临床泌尿外科杂志,2018,33(5):390-392,397.
13 Behzadi P,Behzadi E,Ranjbar R.Urinary tract infections and Candida albicans[J].Cent European J Urol,2015,68(1):96-101.
14胡跃世,李鹏,曹志华,等.尿路真菌感染调查与药敏分析[J].中华医院感染学杂志,2016,26(5):1053-1055.
15易玲娴.综合ICU尿路真菌感染临床特点[J].解放军医学院学报,2014,35(1):68-69.
16 Shu LB,Lu Q,Sun RH,et al.Prevalence and phenotypic characterization of carbapenem-resistant Klebsiella pneumoniae strains recovered from sputum and fecal samples of ICU patients in Zhejiang Province,China[J].Infect Drug Resist,2019,12:11-18.
17 Calia C,Pazzani C,Oliva M,et al.Carbapenemases-producing Klebsiella pneumoniae in hospitals of two regions of Southern Italy[J].Apmis,2017,125(5):491-498.
18梁亮,农生洲,刘晓春,等.2014-2016年广西地区克雷伯菌属细菌耐药性监测[J].中华医院感染学杂志,2018,28(20):3050-3055.
19张慧,王健,吴晓燕,等.159株耐碳青霉烯类肠杆菌科细菌的临床特征和耐药性分析[J].检验医学与临床,2018,15(20):3050-3052,3055.
2 Jacobsen SM,Stickler DJ,Mobley HL,et al.Complicated catheter-associated urinary tract infections due to Escherichia coli and Proteus mirabilis[J].Clin Microbiol Rev,2008,21(1):26-59.
3郑奋薇,蔡桂程,梁美莲,等.重症患者导管相关性尿路感染危险因素分析[J].解放军医学院学报,2018,39(6):494-497.
4 Jadoon SA,Ahmed A,Irshad R.Spectrum Of Bacterial Culture And Drug Sensitivity Vs Resistance In Uncomplicated Urinary Tract Infection[J].J Ayub Med Coll Abbottabad,2018,30(3):432-438.
5黄友明,黄欣,邓峥,等.泌尿系感染分离病原菌分布及耐药性分析[J].实验与检验医学,2018,36(6):935-937.
6邓宁宁,教莹莹,刘沛.ICU医院获得性泌尿道感染病原菌及耐药分析[J].中国医药科学,2018,8(19):223-226.
7丁厚文,刘周,吴园园,等.1127株尿培养病原菌分布及耐药性分析[J].国际检验医学杂志,2018,39(4):477-480.
8郭健莲,谢志雄.泌尿系统真菌感染的分布及其耐药性分析[J].国际检验医学杂志,2014,(13):1681-1682.
9 Chiang CH,Pan SC,Yang TS,et al.Healthcare-associated infections in intensive care units in Taiwan,South Korea,and Japan:recent trends based on national surveillance reports[J].Antimicrob Resist Infect Control,2018,7:129.
10元淑巧,班丽素,赵强,等.泌尿系感染患者病原菌分布及药物敏感性分析[J].解放军医学院学报,2015,36(6):599-602.
11严威,靳情.医院内泌尿道感染患者的病原菌耐药性分析[J].医学信息,2018,31(11):118-120.
12钟芳灵,张玉艳,梁雄发,等.真菌性泌尿系感染的菌群分布及药敏分析[J].临床泌尿外科杂志,2018,33(5):390-392,397.
13 Behzadi P,Behzadi E,Ranjbar R.Urinary tract infections and Candida albicans[J].Cent European J Urol,2015,68(1):96-101.
14胡跃世,李鹏,曹志华,等.尿路真菌感染调查与药敏分析[J].中华医院感染学杂志,2016,26(5):1053-1055.
15易玲娴.综合ICU尿路真菌感染临床特点[J].解放军医学院学报,2014,35(1):68-69.
16 Shu LB,Lu Q,Sun RH,et al.Prevalence and phenotypic characterization of carbapenem-resistant Klebsiella pneumoniae strains recovered from sputum and fecal samples of ICU patients in Zhejiang Province,China[J].Infect Drug Resist,2019,12:11-18.
17 Calia C,Pazzani C,Oliva M,et al.Carbapenemases-producing Klebsiella pneumoniae in hospitals of two regions of Southern Italy[J].Apmis,2017,125(5):491-498.
18梁亮,农生洲,刘晓春,等.2014-2016年广西地区克雷伯菌属细菌耐药性监测[J].中华医院感染学杂志,2018,28(20):3050-3055.
19张慧,王健,吴晓燕,等.159株耐碳青霉烯类肠杆菌科细菌的临床特征和耐药性分析[J].检验医学与临床,2018,15(20):3050-3052,3055.
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