摘要
摘要目的:了解近年来小儿尿路感染病原菌分布及其耐药性。方法:对2()()1年1月～2003年12月274例清洁【}l段尿培养阳性(菌落计数>1{)万jml)患儿作细菌药物耐药性试验。结果:(1)病原菌分布情况如下:主要病原菌依次为大肠埃希菌11)5 株(38.2%),肠球菌49株(1 7.9%),克雷伯菌39株(14.2%),奇异变形杆菌23株(8.4%),表皮葡萄球菌18株(6.6%)·阴沟肠细菌12株(4.4%)。(2)产超广谱8内酰胺酶(。ESBI。)情况:肺炎克雷伯菌、阴沟肠细菌、大肠埃希菌产酶率分别为71.4%、41.7%、25.7%。(3)细菌耐药情况:ESBI。阳性菌与ESBI。阴性菌对阿米卡星、庆大霉素、环丙沙星、阿莫西林j免托维酸耐约率除大肠埃希菌埘阿米卡星、阴沟肠细菌对庆大霉素有显著差异(P<().05)外,其余均无显著差异。ESBI.阴性刚沟肠细菌埘头孢噻肟、头孢他啶、头孢呋辛的耐药率分别为75%、57.1%、71.4%,对阿莫西林j克拉维酸耐药率为71.4%,产ESBI。阴沟肠细菌对阿莫两林/克拉维酸耐药率为10()%。17.4%的坚忍肠球菌及12%的屎肠球菌对万古霉素耐药-但临『未治疗仍有效。结论:尿路感染的病原菌仍以大肠埃希菌为主,但肠球菌、克雷伯菌等其他细菌的比例在上升,产ESBI,菌株增加.仔在双多重耐药性,ESBl。阴性菌.尤其阴沟肠细菌及肠球菌存在严重的耐药情况。
Objective: To investigate the distribution and the drug-resistance situation of pathogenic bacteria in children with urinary tract infection in recent years. Methods: Clean midstream urine samples were submitted for culture from Jan. 2001 to Dec. 2003 and 274 positive isolates ( cfu> 105 /ml) were obtained for antimicrobial susceptibility testing. Results: Among all isolates, Eschencha coli accounted for 38. 2%, followed by Enterococcus (17. 9% ), Klebsiella spp. (14. 2%),Proteus mirabilis (8. 4% ), Staphylococcus epidermidis ( 6. 6 %), Enterobacter cloacae(4. 4%). The ESBLs positive rate was 71. 4% among Klebsiella pneumomae,41. 7% among Enterobacter cloacae and 25. 7% among E. coli, respectively. Singiflcant differences were found in Eschencha coli of resistance rate to amikacin and enterobacter cloacae of resistance rate to gentamicin (p<0. 05),but no differences were found in resistance rate between the other ESBLs positive and negative isolates to amikacin, gentamicin. pipcracillin, and amoxicillin/clavulamc acid. The resistance rate of ESBLs negative Enterobacter cloacae was 71. 4% to cefotaxime,57. 1% to ceflazidime and 71. 4% to cefuroxime. respectively. To amoxicillin/clavulamc acid, the resistance rate of Enterobacter cloacae was 71. 4% in ESBLs negative isolates, while 100% in ESBLs positive ones 17. 4% of resistance rate was observed in Enterococcus durans to vancomycm and 12% in Enterococcus faecium,but there was still and effect of vancomycin on both bacteria m clinical practice. Conclusion: E. coli was still the most frequently isolated pathogenic bacteria, but the proportion of Enterococcus,Klebsiella spp. and the other bacteria appears to be increasing,the same as EBSLs positive isolates. There was multiple resistance to antibiotics in ESBLs positive isolates and severee resistance in ESBLs negative ones,especially in Enterobacter cloacae and Enterococcus.
出处
《中国临床医学》
北大核心
2005年第1期164-165,168,共3页
Chinese Journal of Clinical Medicine
