湖北省中醫院泌尿外科尿培養病原菌分布及耐藥性分析

韓豎霞++周立勤++倪維

[摘要] 目的 監測湖北省中醫院（以下簡稱“我院”）泌尿外科尿培養陽性標本中分離菌的種類及耐藥狀況，為臨床治療合理選擇用藥提供依據，并預防手術后泌尿系統感染。 方法 回顧性分析2015年1月～2016年12月我院泌尿外科送檢的尿培養陽性結果。 結果 共收集泌尿外科患者尿培養標本1447份，培養陽性153份，陽性率為10.5%。153份陽性標本中，革蘭陽性菌49株，占32%；革蘭陰性菌104株，占68%。49株革蘭陽性菌中，前兩位的是糞腸球菌（20株）、屎腸球菌（10株）；104株革蘭陰性菌中，前三位的是大腸埃希菌（52株）、銅綠假單胞菌（25株）和肺炎克雷伯菌（12株）。革蘭陰性菌對亞胺培南、阿米卡星及第四代頭孢的耐藥率較低，革蘭陽性菌對呋喃妥因、利奈唑胺、萬古霉素的耐藥率較低。 結論 我院泌尿外科尿培養的菌群以大腸埃希菌、銅綠假單胞菌及腸球菌為主，并且對抗菌藥物均有不同程度的高耐藥性，臨床上應根據細菌培養及藥敏試驗，合理選用抗菌藥物，最大限度地減少耐藥菌株的產生，預防院內感染。

[關鍵詞] 泌尿外科；尿培養；病原菌；耐藥性

[中圖分類號] R69 [文獻標識碼] A [文章編號] 1673-7210（2017）05（a）-0117-03

Distribution and drug resistance of pathogens from the urine culture of urinary surgery department in hospital of traditional Chinese medicine

HAN Shuxia ZHOU Liqin NI Wei

Department of Clinical Laboratory， Hubei Provincial Hospital of Traditional Chinese Medicine， Hubei Province， Wuhan 430061， China

[Abstract] Objective To monitor the distribution and drug resistance of pathogens from the urine culture of Urinary Surgery Department in Hubei Provincial Hospital of Traditional Chinese Medicine （"our hospital" for short）， for the rational choice of medication to provide a basis for treatment， and to prevent postoperative urinary tract infection. Methods The positive results of the urine culture of Urinary Surgery Department in our hospital from January 2015 to December 2016 were retrospectively analyzed. Results A total of 1447 urine samples were collected from urinary surgery patients， 153 cases were positive culture， the positive rate was 10.5%. Among 153 positive samples， 49 strains were Gram-positive bacteria， accounting for 32%； 104 strains were Gram-negative bacteria， accounting for 68%. The first two strains of 49 Gram-positive bacteria were Enterococcus faecalis （20 strains）， Enterococcus faecium （10 strains）. Among 104 strains of Gram-negative bacteria， the first three were Escherichia coli （52 strains）， Pseudomonas aeruginosa （25 strains） and Klebsiella pneumoniae （12 strains）. Resistant rate of Gram-negative bacteria on imipenem， amikacin and fourth-generation cephalosporins was low. Resistant rate of Gram-positive bacteria on the nitrofurantoin， linezolid， vancomycin was low. Conclusion Cultured flora of urinary culture from the Urinary Surgery Department in our hospital is mainly Escherichia coli， Pseudomonas aeruginosa and Enterococcus. And the antimicrobial agents have different degrees of high resistance. Clinically should be based on bacterial culture and susceptibility testing， the rational use of antibiotics， minimize the production of resistant strains and prevent nosocomial infection.