新疆喀什地区第二人民医院泌尿系统疾病患者病原菌的分布及其耐药性分析
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摘要
目的:分析医院泌尿系统患者病原菌的分布及其耐药性,探讨该地区泌尿系统感染患者病原菌的分布特点,为医院泌尿系统疾病患者临床治疗提供参考。方法:抽取新疆喀什地区第二人民医院2016年9月—2017年3月间泌尿外科住院患者860例资料,采用回顾性分析方法,分析其病原菌的分布及其对抗菌药物的耐药性。结果:860例泌尿系统患者(主要以维吾尔族为主,且婴幼儿占比较高)的样本中分离菌株194株,其中革兰阴性菌151株占77.83%(其中大肠埃希菌105株占69.54%,肺炎克雷伯菌20株占13.24%,产酸克雷伯7株占4.64%,鲍曼不动杆菌4株占2.65%,奇异变形杆菌4株占2.65%);革兰阳性菌株39株占20.10%和真菌4株占2.06%;大肠埃希菌对青霉素类和头孢菌素类的耐药性较高,对碳青酶烯类保持较高敏感性,对哌拉西林-他唑巴坦和阿米卡星的耐药性较低,粪肠球菌等革兰阳性菌对抗菌药物的耐药率较高;白色假丝酵母菌未出现耐药的情况,敏感性均较高。结论:该地区引起泌尿系统感染的病原菌分布较广,主要致病菌为革兰阴性菌,其对抗菌药物的耐药性均较为严重;同时,维吾尔族人群的耐药谱轻微高于汉族;临床治疗期间应根据细菌学指导,选用敏感药物治疗,在未获得明确病原菌前应根据感染及耐药的流行趋势合理选用药物治疗。
Objective: To analyze the distribution and drug resistance of pathogenic bacteria in patients with urinary system in hospital, and to discuss the distribution characteristics of pathogenic bacteria in patients with urinary system infection in this region, so as to provide reference for clinical treatment of patients with urinary system disease in hospital.Methods: The data of 860 cases of inpatients in the urology department of the No.2 people's hospital of Kashi, Xinjiang from September 2016 to March 2017 were extracted, and the distribution of pathogenic bacteria and their resistance to antimicrobial agents were analyzed retrospectively. Results: From samples of 860 patients with urinary system(mainly Uygur and infants occupied higher) 194 strains were isolated, of which 151 strains of gram-negative bacteria accounted for77.83%, 105 strains of E. coli(69.54%), 20 strains of Klebsiella pneumoniae(13.24%), acid producing Klebsiella 7 strains(4.64%), 4 strains of Acinetobacter baumannii(2.65%), SingμLar Proteus 4 cases), accounting for 2.65%;39 gram-positive strains accounted for 20.10% and 4 Fungi accounted for 2.06%. Escherichia coli showed high resistance to penicillin and cephalosporins, but high sensitivity to carbapenems, while low resistance to piperacilin-tazobactam and amikacin, and high resistance to antibiotics in gram-positive bacteria such as enterococcus faecalis. No drug resistance was found in candida albicans. Conclusion: The pathogenic bacteria causing urinary tract infection in this region were widely distributed,and the main pathogenic bacteria were Gram-negative bacteria, and their resistance to antimicrobial drugs was serious.Meanwhile, the drug resistance spectrum of Uygur population was slightly higher than that of Han population. Sensitive drug therapy should be selected according to the guidance of bacteriology during clinical treatment, and rational drug therapy should be selected according to the epidemic trend of infection and drug resistance before the pathogen is identified.
Objective: To analyze the distribution and drug resistance of pathogenic bacteria in patients with urinary system in hospital, and to discuss the distribution characteristics of pathogenic bacteria in patients with urinary system infection in this region, so as to provide reference for clinical treatment of patients with urinary system disease in hospital.Methods: The data of 860 cases of inpatients in the urology department of the No.2 people's hospital of Kashi, Xinjiang from September 2016 to March 2017 were extracted, and the distribution of pathogenic bacteria and their resistance to antimicrobial agents were analyzed retrospectively. Results: From samples of 860 patients with urinary system(mainly Uygur and infants occupied higher) 194 strains were isolated, of which 151 strains of gram-negative bacteria accounted for77.83%, 105 strains of E. coli(69.54%), 20 strains of Klebsiella pneumoniae(13.24%), acid producing Klebsiella 7 strains(4.64%), 4 strains of Acinetobacter baumannii(2.65%), SingμLar Proteus 4 cases), accounting for 2.65%;39 gram-positive strains accounted for 20.10% and 4 Fungi accounted for 2.06%. Escherichia coli showed high resistance to penicillin and cephalosporins, but high sensitivity to carbapenems, while low resistance to piperacilin-tazobactam and amikacin, and high resistance to antibiotics in gram-positive bacteria such as enterococcus faecalis. No drug resistance was found in candida albicans. Conclusion: The pathogenic bacteria causing urinary tract infection in this region were widely distributed,and the main pathogenic bacteria were Gram-negative bacteria, and their resistance to antimicrobial drugs was serious.Meanwhile, the drug resistance spectrum of Uygur population was slightly higher than that of Han population. Sensitive drug therapy should be selected according to the guidance of bacteriology during clinical treatment, and rational drug therapy should be selected according to the epidemic trend of infection and drug resistance before the pathogen is identified.
引文
[1]孟芝君,梁红萍.288株尿培养分离的病原菌分布及耐药性分析[J].中国药物与临床,2013,13(10):1370-1374.
[2]黄景波.泌尿结石患者术前尿培养病原菌分布及耐药性分析[J].云南医药,2014,(35):482-484.
[3] NCCLS. Performance standards for antimicrobial susceptibility testing:Nineteenth Informational supplement[S].NCCLS document M100-S19, 2009.
[4]吴芳芳,许纹,杨乐园.962例尿培养病原菌分布及耐药性分析[J].检验医学,2014,29(8):806-808.
[5]谭公祥,曾小明,余明主,等.输尿管软镜术前尿培养与术后全身反应综合征的关系[J].南昌大学学报:医学版,2014,54(6):41-43.
[6]李俊燕,何海艳,王梅新.160例新疆南疆地区泌尿系结石病例分析[J].新疆医学,2011,41:67-70.
[7]张树琛,鲁炳怀,朱凤霞.尿培养病原菌及其耐药分析[J].实用医技杂志,2014,21(4):370-372.
[8]黄睿,孟晓辉.南疆地区197例患者泌尿系统结石成份分析[J].西部医学,2014,24(10):1997-1999.
[9]肖永红,徐英春.《抗菌药物临床应用管理办法》释义和抗菌药物临床应用培训教材[M].北京:人民卫生出版社,2012,8:55-60.
[10]吴文.泌尿系统常见病原菌及耐药性分析[J].医学信息,2015,28(16):31-32.
[11]武晓英.泌尿系统病原菌感染分布及耐药分析[J].临床医药文献杂志,2014,1(6):24-25.
[2]黄景波.泌尿结石患者术前尿培养病原菌分布及耐药性分析[J].云南医药,2014,(35):482-484.
[3] NCCLS. Performance standards for antimicrobial susceptibility testing:Nineteenth Informational supplement[S].NCCLS document M100-S19, 2009.
[4]吴芳芳,许纹,杨乐园.962例尿培养病原菌分布及耐药性分析[J].检验医学,2014,29(8):806-808.
[5]谭公祥,曾小明,余明主,等.输尿管软镜术前尿培养与术后全身反应综合征的关系[J].南昌大学学报:医学版,2014,54(6):41-43.
[6]李俊燕,何海艳,王梅新.160例新疆南疆地区泌尿系结石病例分析[J].新疆医学,2011,41:67-70.
[7]张树琛,鲁炳怀,朱凤霞.尿培养病原菌及其耐药分析[J].实用医技杂志,2014,21(4):370-372.
[8]黄睿,孟晓辉.南疆地区197例患者泌尿系统结石成份分析[J].西部医学,2014,24(10):1997-1999.
[9]肖永红,徐英春.《抗菌药物临床应用管理办法》释义和抗菌药物临床应用培训教材[M].北京:人民卫生出版社,2012,8:55-60.
[10]吴文.泌尿系统常见病原菌及耐药性分析[J].医学信息,2015,28(16):31-32.
[11]武晓英.泌尿系统病原菌感染分布及耐药分析[J].临床医药文献杂志,2014,1(6):24-25.