Huang Lei, Huang Chenwei, Yan Yan, Sun Liying, Li Haixia
Department of Clinical Laboratory, Peking University First Hospital, Beijing, China.
Front Microbiol. 2022 Jan 27;12:813145. doi: 10.3389/fmicb.2021.813145. eCollection 2021.
Urinary tract infections (UTIs) are among the most common infections worldwide. With continuing trends of antibiotic resistance, the etiological distribution and antibiotic susceptibility surveillance are of great importance for empirical antimicrobial therapy. The risk factors and clinical circumstances of UTI among different age categories varied; thus, the pathogens and antimicrobial susceptibilities of UTI may also change with age. The aim of this study was to compare the etiological profiles and antibiotic resistance patterns of UTIs sorted by different age categories from a tertiary general hospital during a 12-year period.
All positive urine culture results from non-repetitive UTI patients in our hospital from January 2009 to December 2020 were collected retrospectively. The microbial distribution and antibiotic resistance rates were analyzed by WHONET 5.6 software. The etiological profiles sorted by different age categories (newborn, pediatric, adult, and geriatric) and antibiotic resistance rates of the top five pathogens were analyzed.
A total of 13,308 non-repetitive UTI patients were included in our study. was dominant in newborn (45%, = 105), and replaced by in pediatric (34%, = 362), adult (43%, = 3,416), and geriatric (40%, = 1,617), respectively. The etiological profiles of different age categories were divergent, sorted by genders (male and female) and ward types (outpatient, inpatient, ICU, and emergency). , , , , and were the top five pathogens in all age categories. The resistance rates of cefoperazone-sulbactam and piperacillin-tazobactam in were low in all age categories. The resistance rates of other cephalosporins, carbapenems, and fluoroqinolones in were higher in geriatric patients overall. was more resistant than in all age categories. Multidrug resistance increased with age, which was more serious in geriatric patients.
The UTI etiological profiles and antibiotic resistance patterns varied among different age categories, especially in pediatric and geriatric patients; thus, a different antibiotic therapy for various age categories should be considered when initiating empirical antimicrobial therapies.
尿路感染（UTIs）是全球最常见的感染之一。随着抗生素耐药性的持续发展，病原体分布及抗生素敏感性监测对于经验性抗菌治疗至关重要。不同年龄组UTI的危险因素和临床情况各不相同；因此，UTI的病原体及抗菌药物敏感性可能也会随年龄变化。本研究旨在比较一家三级综合医院12年间按不同年龄组分类的UTI的病原体谱和抗生素耐药模式。
回顾性收集我院2009年1月至2020年12月非重复性UTI患者的所有阳性尿培养结果。使用WHONET 5.6软件分析微生物分布及抗生素耐药率。分析按不同年龄组（新生儿、儿童、成人和老年）分类的病原体谱以及前五位病原体的抗生素耐药率。
本研究共纳入13308例非重复性UTI患者。 在新生儿中占主导地位（45%， = 105），在儿童（34%， = 362）、成人（43%， = 3416）和老年（40%， = 1617）中分别被 取代。不同年龄组的病原体谱存在差异，按性别（男性和女性）和病房类型（门诊、住院、重症监护病房和急诊）分类。 、 、 、 和 是所有年龄组的前五位病原体。头孢哌酮 - 舒巴坦和哌拉西林 - 他唑巴坦对 的耐药率在所有年龄组均较低。老年患者总体上对其他头孢菌素、碳青霉烯类和氟喹诺酮类药物的耐药率较高。在所有年龄组中， 比 更耐药。多重耐药性随年龄增加，在老年患者中更严重。
不同年龄组的UTI病原体谱和抗生素耐药模式各不相同，尤其是儿童和老年患者；因此，在开始经验性抗菌治疗时，应考虑针对不同年龄组采用不同的抗生素治疗。
