2017—2018年天津市儿童医院泌尿道感染病原菌分布及耐药性分析  

Analysis on distribution and drug resistance of pathogenic bacteria with urinary tract infection in Tianjin Children’s Hospital from 2017 to 2018

作　　者：黄涛[1] 陈楠[2] 尹桐 于和[1] 孙燕燕[1] HUANG Tao;CHEN Nan;YIN Tong;YU He;SUN Yan-yan(Department of Pharmacy,Tianjin Children’s Hospital,Tianjin 300134,China;Department of Laboratory,Tianjin Children’s Hospital,Tianjin 300134,China)

机构地区：[1]天津市儿童医院药剂科,天津300134 [2]天津市儿童医院检验科,天津300134

出　　处：《现代药物与临床》2019年第12期3772-3777,共6页Drugs & Clinic

摘　　要：目的分析2017-2018年天津市儿童医院泌尿道感染病原菌的分布和耐药性,为临床合理应用抗菌药物提供依据。方法收集2017年1月-2018年12月在天津市儿童医院住院,经尿液培养病原菌阳性的泌尿道感染患儿的病例资料,统计并分析泌尿道感染的病原菌分布和耐药情况。结果共检出667株病原菌,泌尿道感染患儿主要集中于28 d^1岁,构成比为57.9%;科室以肾脏科为主,构成比为56.3%。其中革兰阳性菌320株,占48.0%,主要为屎肠球菌、粪肠球菌、鹑鸡肠球菌和鸟肠球菌;革兰阴性菌337株,占50.5%,主要为大肠埃希菌、肺炎克雷伯菌、变形杆菌属和铜绿假单胞菌;真菌10株,占1.5%。屎肠球菌对氨苄西林、苄青霉素的耐药率为100.0%,粪肠球菌对氨苄西林、呋喃妥因、利奈唑胺、苄青霉素和万古霉素的耐药率为0;鹑鸡肠球菌对氨苄西林、苄青霉素和四环素的耐药率为100.0%;鸟肠球菌对呋喃妥因、左氧氟沙星、利奈唑胺、莫西沙星和万古霉素的耐药率为0。大肠埃希菌对呋喃妥因、阿米卡星的耐药率为0;肺炎克雷伯菌对氨苄西林的耐药率为100.0%;变形杆菌属对头孢他啶、头孢替坦、美罗培南、哌拉西林/他唑巴坦和氨曲南等耐药率为0;铜绿假单胞菌对美罗培南的耐药率为0。产超广谱β内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌对多种抗生素均耐药。结论泌尿道感染的病原菌不同且多样,临床经验用药时应根据病原体耐药情况及患儿个体本身选择不同的抗菌药物,提高治疗的针对性。Objective To investigate the distribution and drug resistance of pathogenic bacteria with urinary tract infection in Tianjin Children’s Hospital from 2017 to 2018, and to provide the reference for reasonable use of antibiotics. Methods The data from children suffering from urinary tract infection with the positive results of urine culture in Tianjin Children’s Hospital from January 2017 to December 2018 were collected, and the distribution and drug resistance of pathogenic bacteria with urinary tract infection were analyzed statistically. Results Total 667 strains of pathogens were isolated. Most of children with urinary tract infection were 28 d - 1 year old, accounting for 57.9%. The specimens mainly distributed in Department of Nephrology, accounting for 56.3%. Gram-positive bacteria bacteria were 320 strains(48.0%), and main of them were Enterococcus faecium, Enterococcus faecalis, Enterococcus gallinarum, and Enterococcus avium. Gram-negative bacteria(337 strains) accounted for 50.5%, and main of them were Escherichia coli, Klebsiella pneumoniae, Proteus, and Pseudomonas aeruginosa. Fungi were 10 strains, accounting for 1.5%. The drug resistance rates of E. faecium against ampicillin and picillin were 100.0%. E. faecalis was completely sensitive to ampicillin, furantoine, linezolid, benzacillin, and vancomycin. The drug resistance rates of E. gallinarum against ampicillin, benzylpenicillin, and tetracycline were 100.0%. E. avium was completely sensitive to furantoin, levofloxacin, linezolomide, moxifloxacin, and vancomycin. E. coli was completely sensitive to nitrofurantoin and amikacin. The drug resistance rate of K. pneumoniae against ampicillin was 100.0%. Proteus was completely sensitive to ceftazidine, cefotetam, meropenem, piperacillin/tazobactam, and aztreonam. P. aeruginosa was completely sensitive to meropenem. E. coli and K. pneumoniae of the positive ESBLs were resistant to multiple antibiotics. Conclusion In order to improve the safety and pertinence of treatment, we should choose antibiotics

关 键 词：抗菌药物 耐药性 病原菌 泌尿道感染 儿童 药敏试验 

分 类 号：R983[医药卫生—药品] R978.1[医药卫生—药学]