泌尿道感染患儿病原菌分布及耐药性分析

Distribution and Drug Resistance of Pathogenic Bacteria of Urinary Tract Infection in Children

目的探讨儿童泌尿道感染的菌群分布及耐药性特点。方法对住院及门诊患儿中段尿培养分离出的555株病原菌进行菌种鉴定及药物敏感试验,并对其结果进行分析。结果在分离的555株病原菌中,革兰阴性杆菌占80.7%,革兰阳性球菌占17.7%,真菌占1.6%。革兰阴性杆菌以大肠埃希菌为主,共检出300株,其中产超广谱β-内酰胺酶(ESBLs)208株,产酶率69.3%;41株肺炎克雷伯菌中检出产ESBLs菌32株,占78.1%。革兰阳性菌以肠球菌为主,共检出70株(12.6%),对万古霉素和夫喃妥因的敏感率为100%。结论儿童泌尿道感染的病原菌以革兰阴性菌为主,细菌耐药严重,临床应重视中段尿细菌培养,合理选用抗生素。

Objective To explore the pathogenic bacteria＇s distribution and their drug resistance of urinary tract infection in children. Methods A total of 555 pathogen strains in urinary tract infection for children from inpatients and outpatients from Jan. 2005 to Dec 2006 were identified and the drug resistance test was preformed. Results In the 555 strains of bacteria,80.7% were Gram - negative, 17.7% were Gram - positive and 1.6 % were fungi. Most of Gram - negative bacteria were E. coli, among 300 strains of identified Escherichia,69.3 % of them （ 208 strains ） produced extended speetrum 13 lactamases（ESBLs） ; among 41 strains of identified Klebsiella pneumoniae ,78.1% of them（ 32 strains） produced ESBLs. Most of Gram - positive bacteria were Enterococcus, there were 70 strains （ 12.6% ）, sensitivity rates of nitrofurantion and vancomycin were 100%. Conclusion Gram - negative is the main infection bacterium in urinary tract infection for children and the most of them are very serious drug resistant. The clinicians should pay more attentions to idstream urin bacteriology culture and choose the suitable antibiotic according to the results of antibiotic susceptibility tests.