小儿尿路感染的病原菌特点及其耐药性分析  

Pathogenic bacteria characteristics and drug resistance of urinary tract infection in children

作　　者：徐璐[1] 张冬雨 张桂珍 Xu Lu;Zhang Dongyu;Zhang Guizhen(Department of Clinical Laboratory,Children's Hospital Affiliated of Zhengzhou University,Henan Provincial Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou Key Laboratory of Children's Infection and Immunology,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院郑州儿童医院检验科,郑州市儿童感染与免疫重点实验室,郑州450000

出　　处：《中国实用医刊》2024年第17期33-36,共4页Chinese Journal of Practical Medicine

摘　　要：目的研究小儿尿路感染(UTI)的病原菌特点及抗菌药物耐药性。方法回顾性抽取2022年1月至2023年12月郑州大学附属儿童医院收治的UTI患儿116例,均采集患儿中段尿液标本进行病原菌培养与药敏试验。分析小儿UTI病原菌特点及对常用抗菌药物的耐药性。结果116份尿液标本中共检测出457株病原菌,其中革兰阴性菌263株(57.55%),占比最高的是大肠埃希菌(33.04%,151/263),其次是肺炎克雷伯菌(6.56%,30/263);革兰阳性菌192株(42.01%),占比最高的是屎肠球菌(21.88%,100/263),其次是粪肠球菌(19.04%,87/263)。大肠埃希菌、肺炎克雷伯菌对粘菌素、替加环素耐药率较低;粪肠球菌、屎肠球菌对万古霉素、替加环素无耐药性。结论小儿UTI致病菌种类繁多,主要为大肠埃希菌、肺炎克雷伯菌、屎肠球菌等,临床应针对病原菌进行药敏试验,并根据药物敏感性情况规范使用抗生素,提高药物治疗效果。Objective To investigate the characteristics of pathogenic bacteria and drug resistance to antibiotics in children with urinary tract infection(UTI).Methods A total of 116 children with UTI admitted to Children's Hospital Affiliated of Zhengzhou University from January 2022 to December 2023 were retrospectively selected,and the midstream urine specimens were collected from the selected children for pathogenic bacteria culture and drug susceptible test.The characteristics of pathogenic bacteria in children with UTI and the resistance to commonly used antibiotics were analyzed.Results In the 116 urine samples,457 strains of pathogenic bacteria were detected out.Among them,263 strains(57.55%)were Gram-negative bacteria,of which the Escherichia coli(33.04%,151/263)had the highest proportion,followed by Klebsiella pneumoniae(6.56%,30/263).Among the 457 strains of pathogenic bacteria,192 strains(42.01%)were Gram-positive bacteria,of which Enterococcus faecium(21.88%,100/263)had the highest proportion,followed by Enterococcus faecalis(19.04%,87/263).The Escherichia coli and Klebsiella pneumoniae had low resistance rates to colistin and tigecycline.Enterococcus faecalis and Enterococcus faecium showed no resistance to vancomycin and tigecycline.Conclusions Various pathogenic bacteria can cause UTI in children,of which Escherichia coli,Klebsiella pneumoniae,Enterococcus faecalis are the predominant strains.Clinical drug susceptible test should be conducted for pathogenic bacteria,and antibiotics should be used regularly according to drug susceptibility to improve the therapeutic effect of drugs.

关 键 词：尿路感染 小儿 病原菌特点 耐药性 

分 类 号：R726.9[医药卫生—儿科] R446.5[医药卫生—临床医学]