1386例小儿中段尿培养病原菌分布及耐药性分析  

Analysis on clinical distribution and drug resistance of pathogenic bacteria in the culture of 1 386 children mid-stream urine

作　　者：蒋鸿超[1] 苏敏[1] 黄海林[1] 奎莉越[1] 温柏平[1] 

机构地区：[1]昆明医科大学附属儿童医院检验中心,云南昆明650000

出　　处：《检验医学与临床》2013年第4期415-416,418,共3页Laboratory Medicine and Clinic

摘　　要：目的分析小儿中段尿培养病原菌的分布及耐药性,以期对儿童临床泌尿系统感染的临床诊疗和预防控制提供有力理论支持。方法对2010～2011年1 386例小儿中段尿培养的病原菌,采用法国生物梅里埃(BioMerieux)VITEK-32全自动微生物分析系统进行鉴定。采用K-B纸片法对病原菌进行常用抗生素的敏感性检测。使用WHONET 5.4软件对原始数据进行分析和统计学处理。结果 2010～2011年尿培养标本1 386例共分离到病原菌138株,阳性率为9.96%。其中革兰阴性菌96株,占69.57%,居前2位的是大肠埃希菌、肺炎克雷伯菌;革兰阳性菌34株,占24.64%,居前2位的是屎肠球菌和粪肠球菌;真菌8株,占5.8%。2年间共分离出大肠埃希菌88株,其中产超广谱β-内酰胺酶菌株56株,比例高达63.64%。结论小儿中段尿培养的病原菌仍以大肠埃希菌为主,泌尿系统感染治疗形势由于细菌多重耐药和交叉耐药日趋严峻,日常了解并监测病原菌分布特点及其耐药情况对临床合理选用抗生素具有重要意义。Objective To analyze the pathogens and antibiltic resistance of urine culture in children for the guidance of clinical treatment and prevention and control of urinary tract infections.Methods From 2010-2011,1 386 cases of urine culture were identified by VITEK-32 instrument and K-B method was used to study the antimicrobial resistance.Data analysis and statistical processing were done by WHONET 5.4 software.Results From 2010 to 2011,138 pathogens were isolated from 1 386 urine samples,with positive rate of 9.96%.In which Gram negative bacilli accounted for 69.57%（96 strains）,the majority was the Escherichia coli（E.coli） and klebsiella pneumoniae;Gram positive cocci accounted for 24.64%（34 strains）.The majority was Enterococcus fasium and Enterococcus faecalis;fungi accounted for 5.8%（8 strains）.88 strains of E.coli were isolated from within the 2 years.And 63.64%（56/88） of which were producing extended spectrum beta lactamases.Conclusion E.coli is the main pathogens cultured from children urine.The situation of clinical treatment of urinary tract infections become worse due to more multi-resistance.Therefore,it is important to daily understand and monitor the pathogen distribution and drug-resistance of E.coli strains for a proper clinical choice of antibiotics.

关 键 词：儿童 泌尿道感染 耐药性 尿液培养 

分 类 号：R56[医药卫生—呼吸系统]