摘要
目的:探讨小儿泌尿系统感染(UTI)病原菌分布、变迁及其耐药性,指导临床安全用药。方法:收集宁夏医科大学总医院儿科2008年1月至2013年12月UTI住院患儿223例,回顾性分析患儿的临床资料及尿培养结果。结果:223例患儿尿培养共检出细菌178株,以革兰阴性菌为主(70.22%),大肠埃希菌居首位(53.93%);其次为革兰阳性菌(28.65%),以屎肠球菌(12.36%)、粪肠球菌(4.49%)多见。对比2008年-2010年及2011年-2013年革兰阳性菌、革兰阴性菌总体分布及前5位致病菌分布情况,革兰阴性菌感染率一直高于革兰阳性菌;革兰阳性菌感染率有上升趋势,屎肠球菌明显增加(P<0.05)。在革兰阴性菌中,大肠埃希菌对氨苄西林耐药率最高,对哌拉西林/他唑巴坦、呋喃妥因、头孢替坦、头孢他啶较为敏感,对亚胺培南全部敏感;革兰阳性菌中屎肠球菌耐药性相对复杂,治疗可选用较敏感的万古霉素、利奈唑胺、替考拉宁。结论:小儿UTI病原菌仍以大肠埃希菌为常见致病菌;革兰阳性菌感染率有上升趋势,以屎肠球菌为主。临床应重视中段尿的培养,加强对病原菌及其耐药性的监测,以便合理选择敏感抗生素,减少耐药菌的产生。
Objective： To investigate the pathogen distribution,change and their drug resistance of children with urinary tract infection（ UTI）,and to guide the clinical medication. Methods： Two hundred and twenty-three cases of hospitalized children which were collected from Ningxia Medical University institute of pediatrics in 2008- 2013 were retrospectively analyzed. Results： A total of 178 strains bacteria were detected,the main was Gram-negative（ G^-） bacteria（ accounting for 70. 22%）,of which the most common was Escherichia coli（ 53. 93%）. Gram-positive（ G^＋） bacteria accounted for 28. 65%,the most common were Enterococci faecium（ 12. 36%） and Enterococcus faecalis（ 4. 49%）. Compared the distribution of G＋bacteria and G-bacteria and the distribution of the top five pathogen in 2008-2010 and 2011-2013,we found that G^-bacteria infection rate had been higher than G＋bacteria; there was an increasing trend in G^＋bacteria infection compared with the previous three years,Enterococcus faecium infection rate was significantly increased（ P〈0. 05）. In G^-bacteria,the resistant rate of Escherichia coli to ampicillin was the highest,it was sensitive to piperacillin /tazobactam,nitrofurantoin,cefotetan,ceftazidime partially,and all sensitive to imipenem. The drug resistance of Enterococci faecium infection was relatively complex,vancomycin,linezolid,teicoplanin could be chose for treatment. Conclusion： The Escherichia coli was still the common pathogenic bacteria in children with UTI; G^＋bacteria infection have a rising trend,the main is Enterococcus faecium.We should pay attention to the cultivation of the middle urine,strengthen the monitoring of pathogens and their drug resistance,in order to rationally choose sensitive antibiotics and reduce the occurrence of drug resistant bacteria.
出处
《儿科药学杂志》
CAS
2015年第3期32-35,共4页
Journal of Pediatric Pharmacy
关键词
儿童
泌尿系统感染
病原菌
耐药性
Children
Urinary tract infection
Pathogen
Drug resistance
