ABSTRACT
Objective To analyze the distribution and drug sensitivity of pathogenic bacteria in urinary tract infection,and to provide evidences for rational use of antibiotics in clinic.Methods The data from 3 677 midstream urine specimens for bacterial culture were retrospectively analyzed.VITEK-2Compact was used to identify bacteria and test drag sensitivity.And WHONETS.6 was used to statistically analyze the data.Results Of 649 strains of pathogenic bacteria from urinary tract infection patients,there were 439 strains of gram-negative bacteria,accounted for 67.6％,among which there were 301 (46.4％) strains of Escherichia coli,and 74 (11.4％) strains of Klebsiella pneumoniae;there were 121 strains of gram-positive cocci,accounted for 18.7％,among which there were 97(14.9％) strains of Enterococcus,and 22 (3.4％) strains of Staphylococcus;there were 89 strains of fungi,accounted for 13.7％.According to drug susceptibility,the sensitive rates of Escherichia coli and Klebsiella pneumoniae to imipenem,cefotetan,piporacillin-tazobactam and amikacin were all over 87.0％.The drug sensitivity of Enterococcus to vancomycin and linezolid were both 100.0％.As to drug resistance to other drags,Enterococcus faecium was higher than Enterococcus faecalis.Conclusion Escherichia coli is the primary pathogenic bacteria of urinary tract infection.Every bacteria strain has a high drug resistance.In clinic,hospital should perform urine bacterial culture and drug sensitivity tests timely,and use antibiotics rationally in order to reduce the production and growth of drug-resistant bacteria.
ABSTRACT
Objective Toinvestigateantimicrobialresistanceamonggram-positivecocciinChinain 2013.Methods Retrospectivestudy.FromJune2013toDecember2013,1663consecutiveandnon-repetitive gram-positive cocci were collected from 15 teaching hospitals. The minimal inhibitory concentration ( MIC) of antibacterial agents was determined by agar dilution method. A retrospective study was conducted on rates of resistance to antimicrobial agents. The prevalence of penicillin-resistant Streptococcus pneumoniae ( PRSP) between children and adult patients and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) between elder group and younger adult patients were compared using chi-square test. Results The prevalence of PRSP in children below 3 years old ( 72. 9%, 51/70 ) was higher than adult patients (55. 2%, 106/192) (χ2 =6. 653,P<0. 05). About 94. 9%(261/275) and (92. 7%,255/275) of S. pneumonia were resistant to erythromycin and clindamycin. All S. pneumoniae strains were susceptible to teicoplanin, vancomycin, linezolid, tigecycline and daptomycin. Penicillin still showed very high activity against Streptococcus spp. β-Hemolytic group. More than 60% of Streptococcus spp.β-Hemolytic group were resistant to erythromycin, clindamycin and tetracyclines. The prevalence of MRSA and methicillin-resistant coagulase-negative Staphylococci(MRCoNS) was 39. 7%(229/576) and 80. 6%(224/278), respectively. The MRSA prevalence ranged from 24. 2% to 70. 0% in different regions. About 52. 6%( 100/190 ) of Staphylococcus aureus from respiratory tract specimens, 38. 5%(40/104)of Staphylococcus aureus from blood samples, and 29. 7%(58/195) of Staphylococcus aureus from wound and pus were resistant to methicillin. The prevalence of MRSA in elder group ( 48. 6%, 84/173 ) was higher than that in younger adult patients (35. 7%, 144/403)(χ2 =8. 322,P <0. 05). The susceptibility rates of MRSA to chloramphenicol and trimethoprim/sulfamethoxazole were 86. 4% ( 244/228 ) and 94. 7% ( 237/228 ) , respectively. Susceptibility rates to gentamycin, erythromycin, clindamycin, tetracyclines, rifampicin and quinolones were ranged from 15. 8% to 59. 6%. All Staphylococci isolates were susceptible to teicoplanin, vancomycin, linezolid, daptomycin and tigecycline. All Enterococcus isolates were susceptible to daptomycin and tigecycline. All E. faecalis ( 158/158 ) and 96. 4% ( 133/138 ) of E. faecium were susceptible to teicoplanin. About 98. 0% ( 150/153 ) of E. faecalis and 97. 1% ( 145/138 ) of E. faecium were susceptible to linezoild. About 45. 8% (70/153) of E. faecalis and 60. 9% (84/138) of E. faecium were resistant to gentamycin with a high concentration. The susceptibility of E. faecalis to all the antibiotics tested exceptchloramphenicolandtetracyclinewashigherthanthatofE.faecium.Conclusions Basedon different age groups and regions, the resistance rates of Gram-positive cocci are different. Teicoplanin, vancomycin, tigecycline, daptomycin, linezolid and tedizolid showed very high activity against Gram-positive cocci. (Chin J Lab Med,2015,38:373-381)