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儿童导管相关尿路感染的病原体发生率及抗生素耐药模式

Pathogen incidence and antibiotic resistance patterns of catheter-associated urinary tract infection in children.

作者信息

Bi Xue-Cheng, Zhang Binghua, Ye Yong-Kang, He Hui-Chan, Han Zhao-Dong, Dai Qi-Shan, Liang Yu-Xiang, Zeng Guo-Hua, Wang Yue-Sheng, Chen Qing-Biao, Zhong Wei-De

机构信息

Southern Medical University, Guangzhou, China.

出版信息

J Chemother. 2009 Dec;21(6):661-5. doi: 10.1179/joc.2009.21.6.661.

Abstract

The aim of this study was to characterize the pathogens and their antibiotic susceptibilities in children with catheter-associated urinary tract infection (CAUTI) in order to optimize empirical antibiotic therapy and prophylaxis. from 2001 to 2006, 895 children with an indwelling catheter from 3 hospitals in China were included in this study, of whom 335 (37.4%) had CAUTI. Antimicrobial susceptibility testing of 450 bacterial isolates was performed using the ClSi broth and Kirby-bauer agar dilution methods. Escherichia coli was the most frequently isolated pathogen, followed by Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus spp. E. coli had higher susceptibility to ceftazidime (87.4%), cefuroxime (85.1%) and cefatrizine (76.6%) than to sulfamethoxazole (SMZ) (8.0%), amoxicillin (21.7%), ampicillin (17.1%) and cefazolin (37.7%). Isolates of Klebsiella pneumoniae and Proteus species had similar patterns as E. coli. S. aureus had lower susceptibility to SmZ (6.8%), ampicillin (8.2%), and amoxicillin (24.7%); the trend of S. epidermidis was similar. This study demonstrates that the Gram-negative species are the predominating uropathogens of CAUti in children. it is important to know the bacterial spectrum and the susceptibility patterns to various classes of antibiotic agents to improve empiric antibiotic therapy of children with CAUTI in China.

摘要

本研究旨在明确导管相关尿路感染(CAUTI)患儿的病原体及其抗生素敏感性,以优化经验性抗生素治疗及预防措施。2001年至2006年,中国3家医院的895例留置导管患儿纳入本研究,其中335例(37.4%)发生CAUTI。采用美国临床和实验室标准协会(CLSI)肉汤稀释法及 Kirby-bauer琼脂稀释法对450株细菌分离株进行药敏试验。大肠埃希菌是最常分离出的病原体,其次为金黄色葡萄球菌、表皮葡萄球菌和肠球菌属。大肠埃希菌对头孢他啶(87.4%)、头孢呋辛(85.1%)和头孢曲嗪(76.6%)的敏感性高于对磺胺甲恶唑(SMZ)(8.0%)、阿莫西林(21.7%)、氨苄西林(17.1%)和头孢唑林(37.7%)。肺炎克雷伯菌和变形杆菌属分离株的药敏模式与大肠埃希菌相似。金黄色葡萄球菌对SMZ(6.8%)、氨苄西林(8.2%)和阿莫西林(24.7%)的敏感性较低;表皮葡萄球菌的趋势相似。本研究表明革兰阴性菌是儿童CAUTI的主要尿路病原体。了解细菌谱及各类抗生素的药敏模式对于改善中国CAUTI患儿的经验性抗生素治疗很重要。

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