尿路结构异常儿童合并泌尿系感染的病原菌分析  

Bacteriological profile of urinary tract abnormalities children with urinary tract infection

作　　者：黄楚君[1] 王德娟[2] 杨丽芬[3] 张建飞 林佳周 林明祥[1] 陈壮桂[3] Huang Chujun;Wang Dejuan;Yang Lifen;Zhang Jianfei;Lin Jiazhou;Ling Mingxiang;Chen Zhuanggui(Department of Pediatrics.Shantou central hospital,Shantou 515031,China;Department of Urology;Department of Pediatrics,the Third Affliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Clinical laboratory,Tumor hospital Affliated to Shantou university,Shantou 515031,China)

机构地区：[1]汕头市中心医院儿科,广东515031 [2]中山大学附属第三医院泌尿外科,广州510630 [3]中山大学附属第三医院儿科,广州510630 [4]汕头大学附属肿瘤医院检验科,广东515031

出　　处：《中华腔镜泌尿外科杂志（电子版）》2018年第4期224-227,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：国家自然科学基金面上项目(81470219);广东省公益研究与能力建设专项资金(2014A020212120)

摘　　要：目的探讨尿路结构异常儿童合并泌尿系感染(UTI)致病菌的分布及药物敏感及耐药情况。方法收集2012年1月至2016年12月中山大学附属第三医院及汕头市中心医院符合UTI住院患儿476例,分为尿路正常组及尿路异常组,比较两组间病原菌构成比及对抗菌药物的敏感和耐药情况。结果尿路异常者162例(肾积水最为常见,占43.83%),尿路正常儿童314例。尿路异常儿童合并感染常见于男性(P<0.05),共检出致病菌166株,革兰氏阴性菌(G-)为主(71.08%),大肠埃希菌占首位(40.36%),肠球菌属居第2位(22.89%),粪肠球菌在尿路异常组常见(χ2=4.59,P=0.032)。两组间常见病原菌耐药性差异无统计学意义。结论尿路结构异常男性儿童易发生泌尿系感染,且肠球菌感染的发生率高于尿路结构正常儿童。Objective To investigate the clinical characteristics, pathogens and drug resistance in urinary tract abnormalities children with urinary tract infection. Methods In a retrospective and observational study between January 2012 and December 2016, children with urinary tract infection were recruitment. Based on radiographic test, patients were divided into the normal urinary tract group and the abnormal urinary tract group. Results Four hundred and seventy six cases were included, and 162 were identified with urinary tract abnormalities, of which the most common diagnosis（43.83%） was hydronephrosis. Male children with urinary tract abnormalities were subjected to recurrent urinary tract infection（UTI）. Fever was the most common clinical presentation. A total of 166 strains of pathogenic bacteria were detected, and gram-negative bacteria were ranking the first（71.08%）. E. coli and Enterococcus were responsible for 40.36% and 22.89% children with UTI, respectively. However, enterococcus faecalis were more frequently detected in children with urinary tract abnormalities. There were no significant difference in bacteria resistance to common use antibiotics between the two groups. Conclusion Male children with urinary tract abnormalities were the risk factor for UTI, especially infection with enterococcus.

关 键 词：泌尿系感染 尿路异常 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R726.9[医药卫生—临床医学]