北京协和医院1990—2009年住院患者尿道感染常见病原菌及其耐药性

张小江; 谢秀丽; 孙宏莉; 杨启文; 王辉; 徐英春

北京协和医院1990—2009年住院患者尿道感染常见病原菌及其耐药性

Pathogens and Antibiotic Resistance of Isolates from Patients with Urinary Tract Infections in Peking Union Medical College Hospital, 1990-2009

摘要

摘要:
目的了解住院患者尿道细菌感染常见病原菌及其对抗菌药物的耐药性。
方法用纸片扩散法对1990-2009年北京协和医院住院患者尿道感染分离的4565株病原菌进行抗菌药物耐药监测。
结果 20年来北京协和医院住院患者尿道感染以大肠埃希菌检出率最高(33%), 其次为粪肠球菌(12%)、屎肠球菌(8%)、凝固酶阴性葡萄球菌(7%)、铜绿假单胞菌(6%)和肺炎克雷伯菌(6%)。2006-2009年产超广谱β-内酰胺酶(extended-spectrum beta-lac-tamases, ESBLs)的大肠埃希菌检出率为60%;大肠埃希菌对亚胺培南、美罗培南和厄他培南均100%敏感, 对环丙沙星和左氧氟沙星的耐药率为77.7%和76.4%。粪肠球菌对呋喃妥因和磷霉素的耐药率均低于10%。
结论住院患者尿道感染最常见的病原菌是大肠埃希菌, 且细菌耐药性呈增长趋势, 临床上应加强细菌耐药监测。

Abstract:
Objective To identify the common pathogens of urinary tract infections and the potential existence of drug resistance.
Methods A total of 4565 clinical isolates from patients with urinary tract infections were collected in Peking Union Medical College Hospital from 1990 to 2009. Antimicrobial susceptibility was detected by disk diffusion method.
Results The most common pathogen identified was E. coli (33%), followed by Enterococcus faecalis (12%), Enterococcus faecium (8%), coagulase negative staphylococcus (7%), Pseudomonas aeruginosa (6%), and Klebsiella pneumoniae (6%). Extended-spectrum beta-lactamases (ESBLs)-producing strains in E. coli isolate was 60% from 2006 to 2009. Strains of E. coli and K. pneumoniae were still highly susceptible to imipenem, meropenem, and ertapenem. The resistance rates of E. coli strains to ciprofloxacin and levofloxacin were 77.7% and 76.4%, respectively. The resistance rates of E. faecalis to nitrofurantoin and fosfomycin were lower than 10%.
Conclusion E. coli is the main cause of urinary tract infection. Bacterial resistance remains a major concern and more efforts should be made in the monitoring of drug resistance.

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