郑州地区264例儿童泌尿道感染病原菌谱与耐药性分析  

Pathogen spectrum and drug resistance of urinary tract infections in 264 children in Zhengzhou

作　　者：王全先[1] 邢鹏[2] 付梦宇 袁恩武[1] 于静 段毅涛 泰淑红[1] 丁燕子 WANG Quan-xian;XING Peng;FU Meng-yu;YUAN En-wu;YU Jing;DUAN Yi-tao;TAI Shu-hong;DING Yan-zi(Department of Laboratory Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou Key Laboratory for In Vitro Diagnosis of Hypertensive Disorders of Pregnancy,Zhengzhou 450052,China;Department of Urology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院检验医学科,郑州市妊娠期高血压疾病体外诊断重点实验室,郑州450052 [2]郑州大学第三附属医院泌尿外科,郑州450052

出　　处：《医药论坛杂志》2024年第3期276-282,288,共8页Journal of Medical Forum

摘　　要：目的 了解郑州地区儿童泌尿道感染的病原菌分布与耐药特点。方法 收集郑州大学第三附属医院自2018年3月至2023年7月尿培养阳性患儿的病史资料,采用全自动微生物分析仪和纸片扩散法进行细菌鉴定和药敏实验,利用SPSS软件进行数据分析。结果 收集264例泌尿道感染患儿资料,分离菌株288株,其中革兰阴性杆菌219株(76.04%),革兰阳性球菌60株(20.83%),念珠菌9株(3.13%)。尿培养病原菌前6位分别为大肠埃希菌、肺炎克雷伯菌、粪肠球菌、铜绿假单胞菌、阴沟肠杆菌复合群、屎肠球菌。革兰阳性球菌分布存在性别差异,男性患儿以粪肠球菌为主,女性患儿以屎肠球菌为主。大肠埃希菌对氨苄西林、头孢曲松和头孢唑林的耐药率均>75%。肺炎克雷伯菌对头孢唑林、头孢曲松、氨曲南、氨苄西林/舒巴坦的耐药率均>60%;粪肠球菌对四环素、红霉素、利福平、高浓度庆大霉素的耐药率均>50%;屎肠球菌对青霉素、环丙沙星、左氧氟沙星、氨苄西林、红霉素的耐药率均>90%。男性患儿的大肠埃希菌对氨苄西林的耐药率高于女性患儿,1岁以上患儿的大肠埃希菌对庆大霉素的耐药率高于1岁以下患儿。此外,肺炎克雷伯菌在1岁以下患儿中对头孢吡肟的耐药率也较高。结论 大肠埃希菌、肺炎克雷伯菌、粪肠球菌是泌尿道感染的主要病原菌,不同年龄和性别患儿病原菌分布和耐药性存在差异,临床应做好院感检测,积极送检尿培养,并根据药敏结果合理用药。Objective To understand the distribution and drug resistance characteristics of pathogenic bacteria in children with urinary tract infections in Zhengzhou.Methods The medical history data of children with positive urine culture in the Third Affiliated Hospital of Zhengzhou University from March 2018 to July 2023 were collected. The bacteria were identified and drug sensitivity tests were performed using an automated microbiological analyzer and paper disk diffusion method. Data analysis was conducted using SPSS software.Results A total of 264 cases of urinary tract infections in children were collected, with 288 strains of isolated bacteria, including 219 strains of Gram-negative bacilli(76.04%), 60 strains of Gram-positive cocci(20.83%), and 9 strains of Candida(3.13%). The top six pathogens isolated from urine cultures were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Pseudomonas aeruginosa, Enterobacter cloacae complex, and Staphylococcus saprophyticus. There was a gender difference in the distribution of Gram-positive cocci, with Enterococcus faecalis being predominant in male patients and Staphylococcus saprophyticus being predominant in female patients. Escherichia coli showed resistance rates above 75% to ampicillin/sulbactam, ceftriaxone, and ceftazidime. Klebsiella pneumoniae showed resistance rates above 60% to ceftazidime, ceftriaxone, amikacin, and ampicillin/sulbactam. Enterococcus faecalis showed resistance rates above 50% to tetracycline, erythromycin, levofloxacin, and high-concentration gentamicin. Staphylococcus saprophyticus showed resistance rates above 90% to penicillin, ciprofloxacin, levofloxacin, ampicillin/sulbactam, and erythromycin. The resistance rate of Escherichia coli to ampicillin/sulbactam was higher in male patients than of female patients, and the resistance rate of Escherichia coli to gentamicin was higher in patients over 1 year old than of those under 1 year old. In addition, Klebsiella pneumoniae showed a higher resistance rate to cefepime in patients unde

关 键 词：泌尿道感染 儿童 病原菌 耐药性 

分 类 号：R726[医药卫生—儿科]