儿童泌尿道感染的病原菌特点及耐药性分析  

作　　者：林园 徐卫华 

机构地区：[1]安徽医科大学儿童医学中心,230051

出　　处：《浙江临床医学》2025年第1期43-45,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 分析儿童泌尿道感染的病原菌特点及耐药性。方法 回顾性分析2022年1月至2023年12月泌尿道感染1398例患者尿液中分离出的288株病原菌特点及其耐药情况。结果 初诊泌尿道感染患儿1398例中检出病原菌288株。其中革兰阴性菌206株(71.5%),革兰阳性菌72株(25%),真菌10株(3.5%);革兰阴性细菌前4种病原菌分别是大肠埃希菌138株(66.9%),肺炎克雷伯菌肺炎亚种26株(12.6%),铜绿假单胞菌8株(9.0%),柠檬酸杆菌6株(2.9%);革兰氏阳性菌以屎肠球菌44株(61.1%)和粪肠球菌23株(31.9%)为主。药敏实验结果显示:大肠埃希菌对氨苄青霉素耐药率79.71%,头孢类抗生素耐药率依次为头孢唑林58.70%,头孢曲松55.07%,头孢吡肟45.65%,头孢他啶24.64%,对头霉素类及β内酰胺酶抑制剂类药物耐药率较低,极少数对碳青霉烯类药物耐药。肺炎克雷伯菌肺炎亚种对大部分抗生素耐药率普遍高于大肠埃希菌。产超广谱β内酰胺酶(ESBLs)菌株对常用抗菌药物耐药率明显高于非产酶菌株。粪肠球菌对青霉素及糖肽类药物普遍敏感,屎肠球菌对青霉素类药物高度耐药率100%。结论 儿童泌尿道感染致病菌种类较多,以大肠埃希菌最常见,产ESBLs菌株对临床常用抗菌药物耐药率更高,肺炎克雷伯菌对碳青霉烯类药物耐药形势尤为严峻,应高度重视。Objective To analyse the characteristics and drug resistance of pathogenic bacteria in pediatric urinary tract infections.Methods Retrospectively analysed the characteristics and drug resistance of 288 pathogenic bacteria isolated from the urine of patients with urinary tract infections from January 2022 to December 2023. Results 288 strains of pathogens were isolated in 1398 cases of children with the initial diagnosis of urinary tract infections,including 206 strains of gram-negative bacteria(71.5%),72 strains of gram-positive bacteria(25%) and 10 strains of fungi(3.5%). The top four pathogens of Gram negative bacteria were 138 strains(66.9%) of Escherichia coli,26 strains(12.6%) of Klebsiella pneumoniae subsp. pneumoniae,8strains(9.0%) of Pseudomonas aeruginosa,and 6 strains(2.9%) of Citrobacter. Gram positive bacteria were mainly composed of 44 strains(61.1%) of Enterococcus faecalis and 23 strains(31.9%) of Enterococcus faecalis. The drug sensitivity test results showed that the resistance rate of Escherichia coli to ampicillin was 79.71%,and the resistance rates to cephalosporin antibiotics were 58.70% for cefazolin,55.07% for ceftriaxone,45.65% for cefepime,and 24.64% for ceftazidime. The resistance rates to cephalosporin and β-lactamase inhibitors were relatively low,with very few resistant to carbapenems.Klebsiella pneumoniae subspecies pneumoniae had a higher rate of resistance to most antimicrobial drugs than Escherichia coli. Extended-spectrum beta-lactamases(ESBLs)-producing strains showed significantly higher rates of resistance to commonly used antimicrobial drugs than non-producing enzyme strains. Enterococcus faecalis was generally susceptible to penicillins and glycopeptides,and Enterococcus faecium was highly resistant to penicillins(100%). Conclusion Urinary tract infections in hospitalized children have a wide range of causative organisms and Escherichia coli is the most common pathogen,ESBLs-producing strains have a higher rate of resistance to commonly used clinical antimicrobial drugs. Th

关 键 词：儿童 泌尿道感染 耐药性 

分 类 号：R44[医药卫生—诊断学]