儿童泌尿系感染病原菌分布及耐药性分析  

Analysis of distribution and drug resistance of pathogen in children with urinary tract infection

作　　者：郭建群[1] 马颐姣[1] 贾实磊[1] 高晓洁[1] GUO Jian-qun;MA Yi-jiao;JIA Shi-lei;GAO Xiao-jie(Kidney and Traditional Chinese Medicine Ward,Shenzhen Children'sHospital,Shenzhen 518038,Guangdong,China)

机构地区：[1]深圳市儿童医院肾脏中医病区,广东深圳518038

出　　处：《广东医学》2020年第15期1577-1580,共4页Guangdong Medical Journal

摘　　要：目的探讨儿童泌尿系感染病原菌的分布及耐药性,为临床合理选用抗生素提供参考依据.方法对泌尿系感染患儿尿培养分离的297株病原菌进行病原鉴定和耐药性分析.结果在分离的297株病原菌中,分离出革兰阴性菌212株(71.4%),革兰阳性菌75株(25.2%),真菌10株(3.4%).革兰阴性菌中以大肠埃希菌最多见,其次为肺炎克雷伯菌等.革兰阳性菌中以屎肠球菌检出率最高,其次为粪肠球菌等.药敏试验表明:大肠埃希菌对头孢曲松耐药率较高,其后依次为头孢他啶、头孢替坦等.粪肠球菌对加酶抑制剂的青霉素类抗生素普遍敏感.屎肠球菌可选用万古霉素或利奈唑胺.结论泌尿系感染致病菌种类较多,以大肠埃希菌最为多见,临床上需注意尿培养留取并根据药敏试验结果调整抗生素使用.Objective To investigate the distribution and drug resistance of pathogen in urinary tract infection in children, and to provide a reference for rational drug selection. Methods A total of 297 pathogen isolated from urine culture of children with urinary tract infection were identified and analyzed for drug resistance. Results Among the 297 strains isolated, 212 strains of Gram-negative bacteria(71.4%), 75 strains of Gram-positive bacteria(25.2%) and 10 strains of fungi(3.4%) were isolated. Among the Gram-negative bacteria, Escherichia coli was the most common, followed by Klebsiella pneumoniae. Among the Gram-positive bacteria, the detection rate of Enterococcus faecium was the highest, followed by Enterococcus faecalis. Drug susceptibility test showed that Escherichia coli and Klebsiella pneumoniae had higher resistant rate to ceftriaxone, followed by ceftazidime, cefepime, piperacillin tazobactam and meropenem. Enterococcus faecalis was generally sensitive to penicillin antibiotics with enzyme inhibitor. Vancomycin or linezolid could be selected for Enterococcus faecium infection. Conclusion There are many kinds of pathogenic bacteria in urinary tract infection in children. Escherichia coli is the most common. It is necessary to pay attention to the retention of urine culture and adjust the use of antibiotics according to the results of drug susceptibility test.

关 键 词：泌尿道感染 病原菌 抗菌药 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R695[医药卫生—临床医学]