Alberici Irene, Bayazit Aysun Karabay, Drozdz Dorota, Emre Sevinç, Fischbach Michel, Harambat Jérôme, Jankauskiene Augustina, Litwin Mieczyslaw, Mir Sevgi, Morello William, Peco-Antic Amira, Sallay Peter, Sever Lale, Simonetti Giacomo D, Szczesniak Przemyslaw, Teixeira Ana, Vidal Enrico, Wuehl Elke, Mehls Otto, Weber Lutz T, Schaefer Franz, Montini Giovanni
Nephrology and Dialysis Unit, Department of Pediatrics, Azienda Ospedaliera Universitaria Sant'Orsola-Malpighi Bologna, Via Massarenti 11, 40138, Bologna, Italy,
Eur J Pediatr. 2015 Jun;174(6):783-90. doi: 10.1007/s00431-014-2459-3. Epub 2014 Nov 28.
Knowledge of the distribution spectrum of causative organisms and their resistance patterns has become a core requirement for the rational and effective management of urinary tract infections. In the context of a prospective trial on the use of antibiotic prophylaxis in infants with underling kidney malformations, we conducted an online survey among paediatric nephrologists on positive urine cultures (July 2010-June 2012) from both hospitalized and non-hospitalized infants under 24 months of age. We collected 4745 urine cultures (UCs) at 18 units in 10 European countries. Escherichia coli was the most frequent bacterium isolated from UCs; however, in 10/16 hospitals and in 6/15 community settings, E. coli was isolated in less than 50% of the total positive UCs. Other bacterial strains were Klebsiella, Enterococcus, Proteus and Pseudomonas not only from hospital settings. E. coli showed a high resistance to amoxicillin and trimethoprim and variable to cephalosporin. Nitrofurantoin had a good rate of efficacy, with 11/16 hospitals and 11/14 community settings reporting a resistance lower than 5%.
E. coli is the most common organism causing UTIs in infants; however, other bacterial strains are frequently isolated. As a result, antibiotic prophylaxis should be more elastic and adaptable over time in order to guarantee maximum efficacy.
了解致病微生物的分布谱及其耐药模式已成为合理有效管理尿路感染的核心要求。在一项关于对患有潜在肾脏畸形的婴儿使用抗生素预防的前瞻性试验背景下，我们对儿科肾脏病专家进行了一项在线调查，调查对象为24个月以下住院和非住院婴儿的尿培养阳性结果（2010年7月至2012年6月）。我们在10个欧洲国家的18个单位收集了4745份尿培养样本。大肠杆菌是从尿培养样本中分离出的最常见细菌；然而，在16家医院中的10家以及15个社区环境中的6个中，大肠杆菌在总阳性尿培养样本中的分离率不到50%。其他细菌菌株包括克雷伯菌、肠球菌、变形杆菌和假单胞菌，不仅来自医院环境。大肠杆菌对阿莫西林和甲氧苄啶表现出高耐药性，对头孢菌素的耐药性则有所不同。呋喃妥因的有效率良好，16家医院中的11家以及14个社区环境中的11个报告其耐药率低于5%。
大肠杆菌是婴儿尿路感染最常见的致病菌；然而，其他细菌菌株也经常被分离出来。因此，抗生素预防应随着时间的推移更具弹性和适应性，以确保最大疗效。
