目的 了解尿路感染致病微生物谱及主要致病菌的耐药性,以指导临床合理用药.方法 回顾性分析2005-2007年住院患者中段尿培养阳性的3117株致病微生物鉴定结果和主要致病菌耐药率.结果尿路感染致病微生物仍以细菌为主,其次为真菌、支原体和衣原体.大肠埃希菌仍占革兰阴性菌的首位,其中产超广谱β-内酰胺酶（esbls）阳性的比例高达51.2%,且耐药性明显高于esbls（-）菌株.主要革兰阳性球菌对万古霉素100%敏感,对呋喃妥因和氨苄西林相对敏感.结论 尿路感染致病微生物仍以大肠埃希菌为主,但应关注真菌及支原体和衣原体感染的增加.临床上需根据药物敏感性试验结果慎重选择抗菌药物,并尽量避免联合使用抗菌药物.; abstract：; objective to identify the spectrum of pathogenic microorganisms of urinary tract infection and the drug resistance in a hospital setting. methods the pathogenic microorganisms isolated from 3117 mid-stream urine samples of patients admitted in hangzhou first people’s hospital from 2005 to 2007 and their drug resistance results were retrospectively analyzed. results bacteria were the most prevalent microorganisms in the urinary tract infection, and followed by fungus, mycoplasma and chlamydia. escherichia eoli accounted for the largest proportion of gram-negative bacteria, in which the esbls positive strains accounted for 51.2%, and their drug resistance rate was much higher than that of esbls negative strains. main gram-positive coccobacteria was all sensitive to vancomycin, and relatively sensitive to nitrofurantnin and ampicillin. conclusions escherichia coli continue to prevail upon the spectrum of pathogenic microorganism of the urinary tract infection, and the fungus, mycoplasma and chlamydia infections are rising. antibacterial agents should be used under the guidance of drug sensitivity test, and the combined use should be avoidd.
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