2 085例小儿尿路感染病原菌与耐药性分析

来源 :中国实用医刊 | 被引量 : 0次 | 上传用户:angel190000
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目的:评价尿路感染患儿病原菌的分布特点及耐药性,旨在为小儿尿路感染的治疗提供理论依据。方法:回顾性分析2014年1月至2019年12月在郑州大学附属郑州中心医院儿科治疗的2 085例尿路感染患儿的尿培养与药敏结果。结果:共收集2 238份尿液标本,检出菌株240株(10.72%),其中真菌2株(0.83%),革兰阳性菌87株(36.25%),革兰阴性菌151株(62.92%)。分离率较高的病原菌分别为肺炎克雷伯菌(11.67%,28/240)、肠球菌(29.99%,72/240)与大肠埃希菌(41.25%,99/240)。2014—2019年,肠球菌和大肠埃希菌阳性检出率逐年提高,其中2019年肠球菌分离率(χn 2=5.438,n P=0.020)、大肠埃希菌检出率(χn 2=4.749,n P=0.029)与超广谱β-内酰胺酶(ESBLs)阳性率(χn 2=8.181,n P=0.004)较2014年提高。铜绿假单胞菌、肺炎克雷伯菌与大肠埃希菌对亚胺培南敏感,耐药率均为0;对部分头孢菌素类抗生素和氨苄西林高度耐药,耐药率>70.00%。肠球菌耐药率较低的抗生素分别为利奈唑胺(0.00%,0/72)、呋喃妥因(16.67%,12/72)、万古霉素(4.17%,3/72)。n 结论:肺炎克雷伯菌、肠球菌与大肠埃希菌是院内尿路感染患儿的常见病原菌,其中肠球菌检出率逐年提高,同时ESBLs的检出率也迅速提高,且具有较高的耐药率。“,”Objective:To evaluate the distribution characteristics and drug-resistant of pathogens of urinary tract infection in children, and to provide theoretical basis for the treatment of children with urinary tract infection.Methods:The urine culture and drug sensitivity of 2 085 children with urinary tract infection treated in Department of Pediatrics, Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2014 to December 2019 were analyzed retrospectively.Results:A total of 2 238 urine samples were collected, in which 240 strains (10.72%) of pathogens were detected, including 2 strains (0.83%) of fungi, 87 strains (36.25%) of Gram-positive bacteria, and 151 strains (62.92%) of Gram-negative bacteria. The pathogens with high isolation rate included Klebsiella pneumoniae (11.67%, 28/240), Enterococcus (29.99%, 72/240), and Escherichia coli (41.25%, 99/240). From 2014 to 2019, the positive detection rates of Enterococcus and Escherichia coli increased year by year, while the isolation rates of Enterococcus (χn 2=5.438, n P=0.020), Escherichia coli (χn 2=4.749, n P=0.029), and extended-spectrum β-lactamase (χ n 2=8.181, n P=0.004) in 2019 were significantly higher than those in 2014. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli were sensitive to imipenem, and the drug resistance rate was 0. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli were highly resistant to a part of cephalosporins and ampicillin, and the drug resistance rate was more than 70.00%. The antibiotics agaist Enterococcus with lower resistance rate were linezolid (0.00%, 0/72), nitrofurantoin (16.67%, 12/72), vancomycin (4.17%, 3/72).n Conclusions:Klebsiella pneumoniae, Enterococcus, and Escherichia coli are the common pathogens of nosocomial urinary tract infection in children. The detection rate of Enterococcus in children increases year by year, and the detection rate of extended-spectrum β-lactamase also increases rapidly, with high drug resistance rate.
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