患儿尿路感染病原菌分布与耐药性分析

Distribution and drug resistance of pathogenic bacteria in children with urinary tract infection

目的分析患儿尿路感染的病原菌分布及其耐药性,为合理使用抗菌药物,以提高临床治愈率提供理论依据。方法选取2008年1月-2014年12月248例尿路感染的住院患儿,采集患儿中段尿标本进行细菌的分离培养鉴定及药敏试验,菌株鉴定采用法国生物梅里埃公司细菌自动鉴别系统,药敏试验采用K-B纸片扩散法。结果 248例尿路感染患儿标本中共检出病原菌178株,其中革兰阴性菌137株占76.97%,革兰阳性菌35株占19.66%,真菌6株占3.37%;主要革兰阴性菌对亚胺培南耐药率为0,对头孢他啶、哌拉西林、他唑巴坦耐药率均<30.00%,主要革兰阳性菌对利奈唑胺及替考拉宁耐药率0,对万古霉素、磷霉素、利福平、亚胺培南均<35.00%。结论患儿尿路感染病原菌主要以革兰阴性菌为主,临床根据药敏试验结果合理应用抗菌药物,可预防耐药菌株的形成和复发感染。

OBJECTIVE To study the distribution and drug resistance of pathogenic bacteria in children with urinary tract infection,so as to raise the clinical cure rate.METHODS Totally 248 children with urinary infections who were hospitalized from Jan 2008 to Dec 2014 were enrolled in the study,their urine specimens were collected to make isolated culture and drug sensitive test.Bacteria identification system made by BioMerieux was used for bacteria detection and K-B disk diffusion was adopted for drug sensitivity test.RESULTS A total of 178 strains of pathogenic bacteria were detected,among which there were 137 strains of gram-negative bacteria,accounting for76.97%,35 strains of gram-positive bacteria,accounting for 19.66%,and 6strains of fungi,accounting for3.37%.The main gram-negative bacteria were fully sensitive to Imipenem（drug resistance rate was 0）,followed by ceftazidime,piperacillin,tazobactam（the drug resistance rate were 〈30.00%）;the main gram-positive bacteria were fully sensitive to vancomycin and linezolid（drug resistance was 0）,followed by rifampicin,fosfomycin,imipenem.CONCLUSION Gram-negative bacteria is the main pathogenic bacteria for children with urinary tract infection.It is helpful to prevent the drug-resistant strain and recurrence of hospital urinary tract infection by clinical rational use of antimicrobial agents on the drug sensitive test.