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儿童尿路感染中的抗生素耐药性:单中心经验

Antibiotic resistance in childhood urinary tract infections: A single-center experience.

作者信息

Samancı Serhat, Çelik Muhittin, Köşker Muhammet

机构信息

Department of Pediatrics, Diyarbakır Children's Diseases Hospital, Diyarbakır, Turkey.

Division of Neonatology, Department of Pediatrics, Diyarbakır Children's Diseases Hospital, Diyarbakır, Turkey.

出版信息

Turk Pediatri Ars. 2020 Dec 16;55(4):386-392. doi: 10.14744/TurkPediatriArs.2020.22309. eCollection 2020.

Abstract

AIM

Urinary tract infections are the most common genitourinary tract disease in children, and inappropriate antibiotic and/or dose selection increase the likelihood of resistance. The aim of this study was to determine the prevalence of urinary tract infection pathogens, patterns of resistance to antibiotics, and empirical treatment options.

MATERIAL AND METHODS

Between January 2013 and December 2017, urine culture and antibiogram results of pediatric patients aged 0 days to 16 years were analyzed retrospectively. Antibiotic susceptibilities were determined using disc diffusion according to methods of the Clinical and Laboratory Standards Institute.

RESULTS

Of the 1326 children with culture growth, 1070 (80.6%) were female and 256 (19.3%) were male. The most common microorganism found was (1138, 85.8%) E. Coli, followed by Klebsiella spp. (71, 5.3%), Enterobacter spp. (44, 3.3%), and Proteus spp. (28, 2.1%). High frequency of resistance to ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, cefuroxime axetil, as TMP-SMX was detected in all microorganisms, whereas resistance to amikacin, meropenem, imipenem, ertapenem, fosfomycin, and nitrofurantoin was low.

CONCLUSION

E. coli was the most common causative agent of urinary tract infections in childhood. High resistance to ampicillin, ampicillin-sulbactam, amoxicillin-clavulanate, cefuroxime axetil, and TMP-SMX was detected in all agents in our center.

摘要

目的

尿路感染是儿童最常见的泌尿生殖道疾病,抗生素选择不当和/或剂量选择不当会增加耐药的可能性。本研究的目的是确定尿路感染病原体的流行情况、抗生素耐药模式以及经验性治疗方案。

材料与方法

回顾性分析2013年1月至2017年12月年龄在0天至16岁的儿科患者的尿培养和药敏试验结果。根据临床和实验室标准协会的方法,采用纸片扩散法测定抗生素敏感性。

结果

在1326例有培养生长的儿童中,1070例(80.6%)为女性,256例(19.3%)为男性。最常见的微生物是大肠杆菌(1138例,85.8%),其次是克雷伯菌属(71例,5.3%)、肠杆菌属(44例,3.3%)和变形杆菌属(28例,2.1%)。在所有微生物中均检测到对氨苄西林、氨苄西林-舒巴坦、阿莫西林-克拉维酸、头孢呋辛酯和复方磺胺甲恶唑的高耐药率,而对阿米卡星、美罗培南、亚胺培南、厄他培南、磷霉素和呋喃妥因耐药率较低。

结论

大肠杆菌是儿童尿路感染最常见的病原体。在我们中心所有病原体中均检测到对氨苄西林、氨苄西林-舒巴坦、阿莫西林-克拉维酸、头孢呋辛酯和复方磺胺甲恶唑的高耐药率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b3a/7750337/4f767a1aa4ee/TPA-55-386-g001.jpg

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