摘要
目的了解小儿尿路感染病原菌的构成和药敏试验,以指导临床用药.方法我院自2000年1月～2004年12月,尿路感染收治入院患儿的尿液做细菌培养和药敏试验,并对其分析.结果102份尿液共培养出菌株114株,菌株以大肠杆菌为主,占65.79%;其次依次是肺炎克雷伯菌(6.14%)、粪肠球菌(4.39%)、绿脓杆菌(4.39%)、奇异变形杆菌(3.51%)、屎肠球菌(3.51%)等;革兰氏阳性菌,尤其是肠球菌属的检出率上升.氨苄青霉素、复方新诺明、庆大霉素、头孢唑啉对病原菌的耐药性均在50%以上.第二、第三、第四代头孢的药物敏感性逐渐升高;阿米卡星、环丙沙星的药物敏感性均在50%以上;泰能对杆菌的敏感性最高(98%);呋喃妥因对革兰氏阴性和阳性菌的敏感性均较高;稳可信对革兰氏阳性菌的敏感性最高.结论小儿尿路感染病原菌构成仍以大肠杆菌为主.氨苄青霉素、复方新诺明、庆大霉素、头孢唑啉已不能作为小儿尿感的首选用药.第三代头孢、呋喃妥因可作为首选用药.阿米卡星、环丙沙星可作为较大儿童的选择用药.泰能、马斯平可作为危重病例和顽固病例的用药.稳可信可作为革兰氏阳性菌的重要药物.但应在用药之前作尿液的培养、菌计和药敏,并根据药敏指导用药.
Objective To investigate bacterial distribution and resistance status in children with urinary tract infection. Methods A total of 114 strains of bacterium isolated from 102 hospitalized patients with urinary tract infection were identified and test of antibiotic resistance was performed from Jan 2000 to Dec 2004. Results The urinary tract infection was mainly caused by E. Coil （65.79%）, followed by Klebsiella pneumoniae （6.14%）, Enterococcus faecalis （4.39%）, Proteus mirabilis （3.51%） and Enterococcus faecium （3.51%）. Gram positive bacterium, especially Enterococcus specie was increased. Antibiotic susceptibility test revealed a high prevalence of resistance to ampicillin （ 〉 50% ） , cotrimoxazole, gentamicin and cefazolin. Susceptibility to the second, third and fourth generation cephalosporins was relatively higher. Susceptibility to amikacin and ciprofloxacin was above 50%. Imipenem-cilastatin appeared to be the most effective antibiotic against bacterium isolated from this sample. Nitrofurantoin was effective for both gram negitive and gram positive germs. Vaneomycin was the most effective antibiotics against cocci. Conclusion E. coli is the commonest causative bacteria in urinary tract infection in children. Ampicillin, cotrimoxazole, gentamicin and cefazolin is not the adequate selection for treating urinary tract infection. However, third generation cephalosporinsand, and nitrofurantoin may be recommended as the first selection for urinary tract infection. Imipenem-cilastatin, vaneomycin, amikacin and ciprofloxacin may also be used for the serious patients with urinary tract infection.
出处
《上海第二医科大学学报》
CSCD
北大核心
2005年第11期1107-1109,共3页
Acta Universitatis Medicinalis Secondae Shanghai
关键词
儿童
尿路感染
病原菌
药敏试验
children
urinary, tract infection
bacterial
antibiotic susceptibility
