尿路感染儿童1037例高危因素和病原菌群以及耐药性分析  

Analysis of high risk factors,pathogenic flora and drug resistance in 1037children with Urinary tract infection

作　　者：刘诗吟 LIU Shi-yin(Hospital Infection Management Department,Kaifeng Children’s Hospital,Henan,Kaifeng 475000,China)

机构地区：[1]开封市儿童医院感染管理科,河南开封475000

出　　处：《医药论坛杂志》2022年第12期40-43,共4页Journal of Medical Forum

摘　　要：目的分析1037例尿路感染儿童高危因素以及病原菌群、耐药性。方法选取开封市儿童医院2020年8月至2021年8月新生儿科与重症监护室1037例患儿作为研究对象,收集所有患儿的临床资料,分析小儿尿路感染的危险因素,同时收集患儿尿液,经分离培养后分析病原菌的分布情况。此外,对患儿行药敏试验,分析其耐药性。结果1037例患儿中,发生尿路感染138例,发生率13.31%。尿路感染患儿与无尿路感染患儿年龄、住院时间、住院次数以及留置导尿管、合并先天畸形或感染类疾病占比差异具有统计学意义(P<0.05)。Logistic回归分析显示,留置导尿管、合并先天畸形或感染类疾病是导致小儿尿路感染的独立危险因素(P<0.05)。138例尿路感染患儿中,革兰阴性菌共74株,占比53.62%;革兰阳性菌共64株,占比46.38%。革兰阴性菌中以大肠埃希菌为主,占比高达38.41%,革兰阳性菌中屎肠球菌与粪肠球菌的占比均较高,分别为23.19%、16.67%。大肠埃希菌对氨苄西林的耐药性最高(100.00%),其次分别为阿莫西林、庆大霉素、阿米沙星、哌拉西林;屎肠球菌对阿米卡星耐药性最高(100.00%),其次分别为阿莫西林、庆大霉素、头孢噻亏、哌拉西林、氨苄西林;粪肠球菌对阿米卡星的耐药性最高(100.00%),其次分别为头孢噻亏、阿莫西林、哌拉西林、氨苄西林。结论留置导尿管、合并先天畸形或感染类疾病是导致小儿尿路感染的独立危险因素,临床中应重点关注这类高危患儿,预防尿路感染的发生。病原菌分布中已大肠埃希菌、肠球菌为主,临床治疗时应明确患儿的病原菌感染类型,并根据药敏试验结果制定合理的抗生素治疗方案,从而保证治疗的有效性,达到改善患儿预后的目的。Objective To analyze the high-risk factors,pathogenic flora and drug resistance of 1037 children with uri⁃nary tract infection.Methods A total of 1037 children in the neonatology department and intensive care unit of our hospital from August 2020 to August 2021 were selected as the research objects.The clinical data of all children were collected,the risk factors of urinary tract infection in children were analyzed,and the urine of the children was collected.After separating and culturing,analyze the distribution of pathogenic bacteria.In addition,a drug susceptibility test was performed on the children to analyze their drug resistance.Results Among 1037 children,138 cases of urinary tract in⁃fection occurred,the incidence was 13.31%.There were statistically significant differences in the age,length of hospitali⁃zation,number of hospitalizations,indwelling catheters,congenital malformations or infectious diseases between children with urinary tract infection and those without urinary tract infection(P<0.05).Logistic regression analysis showed that indwelling catheters,congenital malformations or infectious diseases were independent risk factors for urinary tract infec⁃tion in children(P<0.05).Among 138 children with urinary tract infection,74 strains of gram-negative bacteria,ac⁃counting for 53.62%;64 strains of gram-positive bacteria,accounting for 46.38%.The majority of gram-negative bacteria are Escherichia coli,accounting for as high as 38.41%,and the proportions of Enterococcus faecium and Entero⁃coccus faecalis in gram-positive bacteria are both 23.19%and 16.67%respectively.Escherichia coli has the highest resistance to ampicillin(100.00%),followed by amoxicillin,gentamicin,amifloxacin,and piperacillin;Enterococcus fae⁃cium has the highest resistance to amikacin(100.00%),followed by amoxicillin,gentamicin,cefotaxime,piperacillin,ampicillin;Enterococcus faecalis has the highest resistance to amikacin(100.00%),followed by cephalosporin Thiazol,amoxicillin,piperacillin,ampicillin.Conclusion Indwe

关 键 词：尿路感染 儿童 高危因素 病原菌群 耐药性 

分 类 号：R691.3[医药卫生—泌尿科学]