中文摘要：

目的 了解泌尿系感染病原菌分布及其耐药性,为尿路感染的诊治提供参考.方法 连续收集2012年4月至2013年3月安徽医科大学第一附属医院门诊及住院患者的6 262份清洁中段尿样本,按操作规程分离培养,采用MicroScan WalkAway 96 Plus及Vitek 2 Compact全自动微生物鉴定及药敏系统进行细菌的鉴定及药敏.用WHONET 5.6软件和SPSS 20.0分别进行耐药性分析和门诊与住院患者分离菌株耐药率比较.结果 共检出l 426株病原菌,其中革兰阳性球菌占25.9％（370株）,革兰阴性杆菌占66.1％（942株）,真菌占8.0％（114株）.革兰阴性杆菌前二位病原菌为大肠埃希菌和肺炎克雷伯菌,革兰阳性球菌以屎肠球菌和粪肠球菌最多见.病原菌对各种抗菌药物表现出不同的耐药性,革兰阴性杆菌中大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌产超广谱β-内酰胺酶（ESBLs）检出率分别为60.5％,51.0％和30.3％;革兰阳性球菌中耐甲氧西林金黄色葡萄球菌及耐甲氧西林凝固酶阴性葡萄球菌的检出率分别为73.3％和86.7％.泌尿系感染常见真菌以白假丝酵母菌和光滑假丝酵母菌多见,其菌株总体耐药率不高.结论 泌尿系感染病原菌以大肠埃希菌为代表的革兰阴性杆菌为主,细菌耐药性形势严峻,有必要建立一个耐药性监测系统.

英文摘要：

Objective To investigate the distribution and drug resistance of pathogens isolated from urinary tract infections.Methods A total of 6 262 midstream urine samples were collected from patients in the First Alfiliated Hospital of Anhui Medical University during April 2012 and March 2013.MicroScan WalkAway 96 Plus or Vitek 2 Compact system was applied in bacteria identification and drug sensitivity test.WHONET 5.6 was adopted to analyze drug resistance,and IBM SPSS 20.0 was applied to compare resistance rates between isolates from outpatients and hospitalized patients.Results A total of 1 426 strains were isolated,in which 370 strains were gram-positive coccus （25.9％）,942 strains were gram-negative bacilli （66.1％） and 114 strains were fungi （8.0％）.Escherichia coli and Klebsiella pneumoniae,Enterococcus faecium and Enterococcus faecalis were the top two among gram-negative bacilli and grampositive coccus,respectively.The prevalence of extended-spectrum β-lactamases （ESBLs）-producing Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were 60.5％,51.0％ and 30.3％,respectively; About 73.3％ of Staphylococcus aureus strains and 86.7％ of coagulase-negative Staphylococcus strains were methicillin-resistant.Candida albicans and Candida glabrata were the two most prevalent fungi in urinary tract infections,and they were sensitive to most antifungal agents.Conclusion Gram-negative bacilli,especially Escherichia coli are the most prevalent pathogen in urinary tract infections,and strains are highly resistant to most antibacterial agents,suggesting that antimicrobial resistance monitoring system is needed.