Koçak Mesut, Büyükkaragöz Bahar, Çelebi Tayfur Asli, Çaltik Aysun, Köksoy Adem Yasin, Çizmeci Zeynep, Günbey Sacit
Department of Pediatrics, Keçiören Training and Research Hospital, Ankara, Turkey.
Department of Pediatric Nephrology, Keçiören Training and Research Hospital, Ankara, Turkey.
Pediatr Int. 2016 Jun;58(6):467-71. doi: 10.1111/ped.12842. Epub 2016 Feb 3.
Urinary tract infections (UTI) are one of the most common bacterial infections in children and a major cause of hospitalization. In this study we investigated the clinical characteristics, causative uropathogens; their antibiotic susceptibility and resistance patterns, treatment modalities and efficacy in children hospitalized for UTI in a tertiary care setting.
Patients hospitalized for an upper UTI between March 2009 and July 2014 were enrolled. The urine culture-antibiogram results and accompanying urinary tract abnormalities were recorded retrospectively.
A total of 142 patients (104 girls, 73.2%; 38 boys, 26.8%) were enrolled. Mean patient age was 32.6 ± 4.1 months. History of recurrent UTI was present in 45.8% (n = 65), with prior hospitalization in 12.0% (n = 17). Frequency of vesicoureteral reflux was 18.3% (n = 26). Gram-negative enteric microorganisms yielded growth in all culture-positive UTI and the most common microorganism was Escherichia coli (n = 114, 80.3%). Extended spectrum beta-lactamase-producing (ESBL (+)) bacterial strains were detected in 49.3% (n = 70), with third-generation cephalosporin resistance in all and increased duration of hospitalization.
The prevalence of UTI with ESBL (+) bacterial strains with multi-drug resistance is increasing in the hospitalized pediatric population, therefore rational use of antibiotics is essential.
尿路感染（UTI）是儿童中最常见的细菌感染之一，也是住院的主要原因。在本研究中，我们调查了三级医疗机构中因UTI住院儿童的临床特征、致病尿路病原体、它们的抗生素敏感性和耐药模式、治疗方式及疗效。
纳入2009年3月至2014年7月因上尿路感染住院的患者。回顾性记录尿培养-药敏结果及伴随的尿路异常情况。
共纳入142例患者（104例女孩，占73.2%；38例男孩，占26.8%）。患者平均年龄为32.6±4.1个月。45.8%（n = 65）的患者有复发性UTI病史，12.0%（n = 17）的患者曾住院治疗。膀胱输尿管反流的发生率为18.3%（n = 26）。革兰氏阴性肠道微生物在所有培养阳性的UTI中均有生长，最常见的微生物是大肠杆菌（n = 114，占80.3%）。检测到49.3%（n = 70）的产超广谱β-内酰胺酶（ESBL(+)）菌株，所有菌株均对第三代头孢菌素耐药，且住院时间延长。
住院儿童中对多种药物耐药的ESBL(+)菌株引起的UTI患病率正在增加，因此合理使用抗生素至关重要。
