摘要
目的 探讨儿童复杂性尿路感染常见致病菌分布及耐药情况.方法 对2011年1月至2013年1月住院治疗的141例尿培养阳性的复杂性尿路感染患者的致病菌分布及常见致病菌药敏进行分析.结果 141例患儿共分离培养出143株病原菌.革兰阴性杆菌是导致儿童复杂性尿路感染的主要致病菌,占56.6％（81/143）,以大肠埃希菌（41.3％,59/143）最常见;革兰阳性球菌占38.5％（55/143）,屎肠球菌和粪肠球菌分别占17.5％（25/143）,14.7％（21/143）;真菌占4.9％（7/143）.大肠埃希菌对阿莫西林耐药率最高为92.0％（23/25）,对亚胺培南（4.3％,2/47）、阿米卡星（6.8％,4/59）和呋喃妥因（6.8％,4/59）的耐药率低.屎肠球菌对利奈唑胺、奎奴普丁、万古霉素和呋喃妥因耐药率低于其他常用抗生素.粪肠球菌对奎奴普丁、四环素、红霉素、利福平的耐药率高于其他常用抗生素.结论 大肠埃希菌、屎肠球菌和粪肠球菌是尿路感染常见致病菌,这些致病菌对多种抗生素耐药率很高,应根据药敏结果调整经验用药.
Objective To investigate the distribution and antibiotic resistance patterns of uropathogens in children with complicated urinary tract infection to guide the empirical antimicrobial treatment.Methods Retrospective analysis of isolated bacteria from 141 children hospitalized with complicated urinary tract infection was performed from January 2011 to January 2013.Results Gram-negative bacillus were the main pathogens [56.6%（81/143）],and Escherichia coli was the leading cause （41.3%,59/143）.Gram-positive bacillus accounted for 38.5% （55/143）,including Enterococcus faecium （17.5%,25/143） and Enterococcus faecalis （14.7%,21/143）.Fungi caused 4.9% （7/143） of the infections.The resistance of Escherichia coli to amoxicillin was the highest [92.0% （23/25）] and resistance to imipenem （4.3%,2/47）,amikacin （6.8%,4/59） and nitrofurantoin （6.8%,4/59） was lower.It was observed resistance of Enterococcus faecium to linezolid,quinupristin,vancomycin and nitrofurantoin was significantly lower than other common antibiotics.The resistance of Enterococcus faecalis to quinupristin,tetracycline,erythromycin,rifampicin was significantly higher than other common antibiotics.Concluusions Escherichia coli,Enterococcus faecium and Enterococcus faecalis are the common uropathogens.These pathogens have a high antibiotic resistance to many common antibiotics.The selection of empirical treatment of children with complicated urinary tract infection should be adjusted by antimicrobial susceptibility test.
出处
《中国医师进修杂志》
2014年第33期30-33,共4页
Chinese Journal of Postgraduates of Medicine
关键词
儿童
复杂性尿路感染
耐药性
尿道病原菌
经验治疗
Children
Complicated urinary tract infection
Antibiotic resistance
Uropathogen
Empirical treatment
