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沙特阿拉伯一家三级医疗中心儿童社区获得性尿路感染:尿路病原体的耐药模式

Community-acquired urinary tract infections in children: Resistance patterns of uropathogens in a tertiary care center in Saudi Arabia.

作者信息

Hameed Tahir, Al Nafeesah Abdullah, Chishti Syed, Al Shaalan Mohammed, Al Fakeeh Khaled

机构信息

Department of Pediatrics, King Abdullah Specialized Children's Hospital, King Abdulaziz Medical City - Central Region, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.

King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

出版信息

Int J Pediatr Adolesc Med. 2019 Jun;6(2):51-54. doi: 10.1016/j.ijpam.2019.02.010. Epub 2019 Mar 8.

Abstract

OBJECTIVE

The aim of the present study was to investigate the bacterial pathogens and their resistance patterns in children presenting with their first admission for a urinary tract infection (UTI) in a large tertiary care center in Riyadh, Saudi Arabia.

METHODS

A retrospective chart review was conducted of pediatric patients 0-14 years of age who were admitted for their first community-acquired UTI in a large tertiary care center in Riyadh, Saudi Arabia. The review covered a 6-year period (2006-2012).

RESULTS

Data were obtained from 202 children, of which 162 (80.2%) were female. The most frequently isolated uropathogens were (75.7%), followed by (9.4%), (5.9%) and species (3.5%). Sixteen (7.9%) isolates were ESBLs. Among all uropathogens, 68% were resistant to ampicillin, 54% resistant to co-trimoxazole, and 30% resistant/intermediate sensitivity to amoxicillin/clavulinic acid. Overall, there was a low resistance rate to cefotaxime (4.4%).

CONCLUSION

is the predominant uropathogen causing UTIs in children, yet there is a high rate of multidrug-resistant organisms. For children admitted for a community-acquired UTI, a third-generation cephalosporin remains an appropriate empiric antibiotic. Our study and the work of others emphasize the importance of choosing empiric antibiotics for pediatric UTIs based on local resistance patterns.

摘要

目的

本研究旨在调查沙特阿拉伯利雅得一家大型三级医疗中心首次因尿路感染(UTI)入院的儿童的细菌病原体及其耐药模式。

方法

对沙特阿拉伯利雅得一家大型三级医疗中心0至14岁首次因社区获得性UTI入院的儿科患者进行回顾性病历审查。审查涵盖6年期间(2006 - 2012年)。

结果

从202名儿童中获取数据,其中162名(80.2%)为女性。最常分离出的尿路病原体是大肠埃希菌(75.7%),其次是肺炎克雷伯菌(9.4%)、奇异变形杆菌(5.9%)和肠球菌属(3.5%)。16株(7.9%)分离株产超广谱β-内酰胺酶(ESBLs)。在所有尿路病原体中,68%对氨苄西林耐药,54%对复方新诺明耐药,30%对阿莫西林/克拉维酸耐药/中介敏感。总体而言,对头孢噻肟的耐药率较低(4.4%)。

结论

大肠埃希菌是导致儿童UTI的主要尿路病原体,但多重耐药菌的发生率较高。对于因社区获得性UTI入院的儿童,第三代头孢菌素仍然是合适的经验性抗生素。我们的研究及其他研究工作强调了根据当地耐药模式为儿童UTI选择经验性抗生素的重要性。

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