儿童尿路感染的病因及抗菌药物耐药模式

Etiology and antimicrobial resistance patterns in pediatric urinary tract infection.

作者信息

Wang Jun, He Lijiao, Sha Jintong, Zhu Haobo, Huang Liqu, Zhu Xiaojiang, Dong Jun, Li Guogen, Ge Zheng, Lu Rugang, Ma Geng, Shi Yaqi, Guo Yunfei

机构信息

Department of Urology, Children's Hospital of Nanjing Medical University, Nanjing, China.

Department of Clinical Laboratory, Children's Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Pediatr Int. 2018 May;60(5):418-422. doi: 10.1111/ped.13526. Epub 2018 Mar 30.

DOI:10.1111/ped.13526

PMID:29394522

Abstract

BACKGROUND

Urinary tract infection (UTI) is one of most common pediatric infections. The aim of this study was to investigate the etiology and antimicrobial resistance patterns in children hospitalized at Children's Hospital of Nanjing Medical University.

METHODS

We conducted a retrospective, descriptive study of all UTI from 1 January 2013 to 30 November 2016 in children discharged from Nanjing Children's Hospital. The isolated pathogens and their resistance patterns were examined using midstream urine culture.

RESULTS

A total of 2,316 children with UTI were included in the study. The occurrence rates of isolated pathogens were as follows: Enterococcus spp., 35.15%; Escherichia coli, 22.32%; Staphylococcus aureus spp., 7.73%; Streptococcus spp., 7.51%; and Klebsiella spp., 6.95%. Uropathogens had a low susceptibility to linezolid (3.47%), vancomycin (0.92%), imipenem (5.74%), and amikacin (3.17%), but they had a high susceptibility to erythromycin (90.52%), penicillin G (74.01%), cefotaxime (71.41%), cefazolin (73.41%), cefuroxime (72.52%), and aztreonam (70.11%).

CONCLUSIONS

There is high antibiotic resistance in hospitalized children with UTI. Susceptibility testing should be carried out on all clinical isolates, and the empirical antibiotic treatment should be altered accordingly.

摘要

背景

尿路感染（UTI）是最常见的儿科感染之一。本研究旨在调查南京医科大学附属儿童医院住院儿童的病因及抗菌药物耐药模式。

方法

我们对2013年1月1日至2016年11月30日从南京儿童医院出院的所有尿路感染患儿进行了一项回顾性描述性研究。使用中段尿培养检查分离出的病原体及其耐药模式。

结果

本研究共纳入2316例尿路感染患儿。分离出的病原体发生率如下：肠球菌属，35.15%；大肠埃希菌，22.32%；金黄色葡萄球菌属，7.73%；链球菌属，7.51%；克雷伯菌属，6.95%。尿路病原体对利奈唑胺（3.47%）、万古霉素（0.92%）、亚胺培南（5.74%）和阿米卡星（3.17%）的敏感性较低，但对红霉素（90.52%）、青霉素G（74.01%）、头孢噻肟（71.41%）、头孢唑林（73.41%）、头孢呋辛（72.52%）和氨曲南（70.11%）的敏感性较高。