中段尿病原微生物培养及耐药性分析对尿路感染患儿抗菌药物合理使用的影响

Effect of Pathogen Culture and Drug Resistance Analysis on rational Use of Antibiotics in Children with urinary Tract Infection

目的探讨中段尿病原微生物培养及耐药性分析对尿路感染患儿抗菌药物合理使用的影响。方法选取河南省永城市中心医院尿路感染患儿192例(2016年10月-2018年4月),均实施中段尿病原微生物培养及药敏试验,统计致病菌分布情况,统计大肠埃希菌、奇异变形杆菌、肺炎克雷伯菌等主要革兰氏阴性菌药敏结果,统计粪肠球菌、屎肠球菌等主要革兰氏阳性菌药敏结果。结果192例标本中,共分离出237株致病菌,其中革兰氏阴性菌构成比为70.89%,而于革兰氏阴性菌中,分离率排在前三位的分别为大肠埃希菌、奇异变形杆菌、肺炎克雷伯菌,革兰氏阳性菌构成比为29.11%,而于革兰氏阳性菌中,分离率排在前两位的分别为粪肠球菌、屎肠球菌;大肠埃希菌、奇异变形杆菌、肺炎克雷伯菌等主要革兰氏阴性菌对头孢他啶、亚胺培南、呋喃妥因、头孢哌酮舒巴坦、丁胺卡那敏感性较高;粪肠球菌、屎肠球菌等主要革兰氏阳性菌对万古霉素、亚胺培南、舒巴坦氨苄西林敏感性较高。结论通过对患儿病原微生物进行培养发现,大肠埃希菌是引起小儿尿路感染主要致病菌,另外通过对常见抗菌药品药敏试验,可有效指导临床医生选择合适的抗菌药品。

Objective To explore the influence of midstream urine pathogenic microorganism culture and drug resistance analysis on rational use of antibiotics in children with urinary tract infection.Methods A total of 192 children with urinary tract infection in Yongcheng central hospital of Henan province(October 2016-April 2018)were selected to carry out midstream urine pathogenic microorganism culture and drug sensitivity test.The distribution of pathogenic bacteria was analyzed,Escherichia coli,proteus mirabilis,klebsiella pneumoniae and other major gram-negative drug sensitivity were analyzed,as same as enterococcus faecalis,enterococcus faecium gram-positive bacteria drug sensitivity.Results A total of 237 strains of pathogenic bacteria were isolated from 192 samples,of which 70.89%was composed of gram-negative.In the gram-negative,escherichia coli,proteus mirabilis and klebsiella pneumoniae were the highest,the gram-positive bacteria ratio was 29.11%,and the highest in the gram-positive bacteria were enterococcus faecalis and enterococcus faecium,respectively escherichia coli,proteus mirabilis,klebsiella pneumoniae and other major gram-negative were highly sensitive to ceftazidime,imipenem,nitrofurantoin,cefperazone sulbactam and amikacin enterococcus faecalis and enterococcus faecium were more sensitive to vancomycin,imipenem and ampicillin than gram-positive bacteria.Conclusion Escherichia coli was found to be the main pathogenic bacteria causing urinary tract infection in children by culturing pathogenic microorganisms in children.In addition,through drug sensitivity test to common antibiotics,the utility model can effectively guide the clinician to choose the appropriate antibacterial drugs.