小儿尿路感染的病原微生物分布及其药物敏感性试验分析

Pathogenic Bacteria Distribution and Drug Sensitivity Test Analysis of Children with Urinary Tract Infection

目的探讨小儿尿路感染的病原微生物分布及常见抗菌药物的药物敏感性(简称药敏)试验。方法回顾性分析医院儿科收治的132例尿路感染患儿的临床资料,探讨其病原微生物分布情况及抗菌药物药敏试验情况。结果 132例患儿尿液共培养出141株菌株,其中,革兰阴性菌占比最高(85.11%),排前3位的菌株分别为大肠埃希菌(68.79%)、奇异变形杆菌(6.38%)及肺炎克雷伯菌(4.96%);革兰阳性菌共19株(13.48%),排前2位的菌株为粪肠球菌(7.09%)和屎肠球菌(4.26%);同时,在尿菌培养中还培养出真菌2株(1.42%)。革兰阴性菌感染时首选头孢哌酮舒巴坦治疗,病情较严重患儿应尽早采用美罗培南治疗;革兰阳性菌感染时首选阿莫西林克拉维酸钾治疗,美罗培南和万古霉素仅对急危重症感染患儿应用。结论导致小儿尿路感染的病原微生物主要为大肠埃希菌,同时,观察常见抗菌药物的药敏试验可用于指导临床用药的选择。

Objective To analyze the pathogenic bacteria distribution and drug sensitivity of common antibiotics in children with urinary tract infection.Methods 132 cases of children with urinary tract infection were selected,the clinical data were retrospectively analyzed,and the distribution of pathogenic bacteria and drug sensitivity test were discussed.Results 141 strains were cultured in132 cases of patients with urinary tract infection.In all strains of gram negative bacteria,the gram negative bacteria accounted for the highest propor-tion of 85.11%,in the gram negative bacteria,the top 3 strains were Escherichia coli,Proteus mirabilis and Klebsiella pneumoniae,the proportions were 68.79%,6.38% and 4.96%;gram positive bacteria were 19 strains,accounting for 13.48%,the top two strains were Enterococcus faecalis and Enterococcus faecium,the proportions were 7.09% and 4.26%;while in the bacterial culture of urine, 2 strains of fungi were cultured,accounting for 1.42%;the preferred Cefoperazone ＋ Sulbactam for treatment of gram negative bacteria infection,for the more serious illness in children,which should make application of imipenem for treatment as soon as possible;the pre-ferred Amoxicillin ＋ Potassium Clavulanate for treatment of gram positive infections,Meropenem and Vancomycin were only used in children with critical illness infection.Conclusion Escherichia coli is the main pathogenic microorganisms that can lead to the occur-rence of urinary tract infection in children,and the observation of drug sensitivity test can be an instruction to clinical drug choice.