摘要
目的探讨泌尿系统先天畸形导致的复发性尿路感染病原菌分布及耐药性特点,为临床合理选用抗菌药物提供依据。方法收集2013年8月至2017年8月深圳市儿童医院收治的伴有泌尿系统先天畸形的复发性尿路感染患儿尿液标本,用VITEK 2COMPACT型全自动细菌培养鉴定仪及其配套的革兰阴性菌、革兰阳性菌鉴定卡、药敏卡进行菌种鉴定及药敏试验。结果 121例患儿初发感染病原菌142株,复发感染病原菌203株,其中39例(32.23%)42株(20.69%)复发感染菌株与初发感染菌株相同。初发组与复发组大肠埃希菌与肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)菌株阳性率差异无统计学意义(P>0.05)。革兰阴性菌占伴泌尿系统先天畸形尿路感染病原菌首位(53.62%),其次为肠球菌属(19.71%);复发感染组屎肠球菌发病率下降,真菌发病率升高,与初发组比较,差异有统计学意义(P<0.05)。初发组及复发组主要革兰阴性菌及革兰阳性菌对所有抗菌药物耐药率差异均无统计学意义(P>0.05)。结论伴泌尿系统先天畸形尿路感染复发患儿较初发患儿相比,病原菌分布有改变,经验用药时不能完全根据初次感染病原菌用药。
Objective To investigate the distribution and drug resistance characteristics of recurrent urinary tract infection caused by congenital malformations of urinary system,and to provide evidence for rational use of antibiotics in clinic.Methods Data of recurrent urinary tract infections with congenital malformations of the urinary system in our hospital from August 2013to August 2017were collected.Strain identification and drug sensitivity test were analyzed by VITEK 2COMPACT analyzer.Results There were 142strains of pathogenic bacteria in 121cases of children with primary infection and 203strains of pathogenic bacteria in recurrent infection.Among them,39cases(32.23%)with 42strains(20.69%)of recurrent infection were the same as those in primary infection.ESBLs production by Escherichia coli and Klebsiella pneumoniae was not significantly different between the initial and recurrent groups(P>0.05).Gram-negative bacteria accounted for 53.62%of the pathogenic bacteria in urinary tract infection with congenital malformation of urinary system,followed by Enterococcus(19.71%).The incidence of Enterococcus fascism decreased and the incidence of fungi increased in the recurrent infection group(P<0.05).There was no significant difference in the resistance rates of all antimicrobial agents between primary and recurrent Gram-negative bacteria and Gram-positive bacteria(P>0.05).Conclusion The distribution of pathogenic bacteria in the recurrence group of urinary tract infection with congenital malformation of urinary system is different from that in the initial group.The experiential use of antibiotics could not depend entirely on the pathogenic bacteria of the first infection.
作者
卢可士
肖伟伟
李守林
刘晓东
王浩
姜俊海
王祥卫
王锐
祝培
LU Keshi;XIAO Weiwei;LI Shoulin;LIU Xiaodong;WANG Hao;JIANG Junhai;WANG Xiangwei;WANG Rui;ZHU Pei(Department of Urology,Shenzhen Children′s Hospital,Shenzhen,Guangdong518038,China;Department of Urology,Shenzhen University General Hospital,Shenzhen,Guangdong518055,China;Department of Clinical Laboratory,Shenzhen Children′s Hospital,Shenzhen,Guangdong518038,China)
出处
《检验医学与临床》
CAS
2019年第6期772-775,778,共5页
Laboratory Medicine and Clinic
基金
广东省深圳市科技计划项目(201507027)
关键词
复发性尿路感染
病原菌
耐药性
recurrent urinary tract infections
pathogenic bacteria
drug resistance
