北京地区单中心儿童泌尿道感染病原菌的动态变迁  

Changes of pathogens in children with urinary tract infection in a single center in Beijing

作　　者：孙金山[1] 陈朝英[1] 李静[1] Sun Jinshan;Chen Chaoying;Li Jing(Department of Nephrology,Children′s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院肾脏内科,北京100020

出　　处：《中华实用儿科临床杂志》2020年第17期1325-1328,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的了解北京地区单中心儿童泌尿道感染病原菌菌群分布及耐药情况,为临床合理使用抗生素提供参考。方法收集2013年1月至2018年5月首都儿科研究所附属儿童医院收治的泌尿道感染患儿的临床资料、尿培养及药敏分析结果并进行回顾性分析。根据发病时间分为2013至2015年组及2016至2018年组,采用SPSS 17.0软件进行临床数据的统计分析。结果共分离出744株病原菌,其中以革兰阴性菌为主(59.4%,442/774株),大肠埃希菌居首位(39.4%,293/744株);其次为革兰阳性菌(36.8%,274/744株),以屎肠球菌(21.8%,162/744株)多见;最后为真菌(3.8%,28/744株)。革兰阴性菌中,大肠埃希菌对氨苄西林耐药性最高(87.6%,255/291株),而对哌拉西林/他唑巴坦耐药率较低(12.7%,37/291株)。对比2013至2015年及2016至2018年革兰阳性、革兰阴性菌及常见病原菌总体分布情况,革兰阴性菌感染率(分别为63.8%和55.5%)持续高于革兰阳性菌(分别为33.1%和40.2%),但革兰阳性菌感染率近年有上升趋势,差异有统计学意义(χ2=4.080,P<0.05)。结论儿童泌尿系感染病原菌以革兰阴性菌为主,其中大肠埃希菌是最常见致病菌,但近年来革兰阳性菌感染率有上升趋势。大肠埃希菌对哌拉西林/他唑巴坦敏感性较高,可考虑作为儿童泌尿系感染治疗的首选药物。大肠埃希菌对第一、二代头孢菌素类抗生素耐药率较高,但对第三代头孢菌素类抗生素如头孢替坦敏感。Objective To investigate the changes of distribution and antimicrobial resistance of pathogens in children with urinary tract infection in a single center in Beijing,and to provide references for the rational use of antibio-tics agent in clinical practice.Methods The clinical data as well as urine culture and drug sensitivity results of children with urinary tract infection treated in the Department of Nephrology,Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2013 to May 2018 were retrospectively analyzed.According to the time of onset,the patients were divided into 2 groups,namely the 2013 to 2015 group and the 2016 to 2018 group.SPSS 17.0 software was used for statistical analysis of clinical data.Results Among the 744 pathogenic bacteria isolated,the most common type was Gram-negative bacteria(59.4%,442/744 strains),and the proportion of Escherichia coli(E.coli)was the highest(39.4%,293/744 strains).Gram-positive bacteria were the second most common(36.8%,274/744 strains),among which,Enterococcus faecium(21.8%,162/744 strains)accounted for the largest proportion(3.8%,28/744 strains).Fungi were the least common type of pathogenic bacteria(3.8%,28/744 strains).In Gram-negative bacteria,E.coli was highly resistant to Ampicillin(87.6%,255/291 strains),but less resistant to Piperacillin/Tazobactam(12.7%,37/291 strains).By comparing the overall distribution of Gram-positive,Gram-negative and common pathogenic bacteria in 2013 to 2015 and 2016 to 2018,the infection rate of Gram-negative bacteria(63.8%,55.5%)was always higher than that of Gram-positive bacteria(33.1%,40.2%),but the infection rate of Gram-positive bacteria has shown an upward trend in recent years,and the differences were statistically significant(χ2=4.080,P<0.05).Conclusions The main pathogenic bacteria of urinary tract infection in children are Gram-negative bacteria,and E.coli is the most common causative bacteria.However,the infection rate of Gram-positive bacteria has been increasing in recent years.E.coli is hig

关 键 词：泌尿系感染 病原菌 耐药性 儿童 

分 类 号：R726.9[医药卫生—儿科]