140株儿童泌尿道感染病原菌分布及耐药性分析

Distribution and Drug Resistance Analysis of 140 Pathogenic Bacteria in Children with Urinary Tract Infection

目的:分析儿童泌尿道感染(UTI)病原菌分布及耐药性。方法:回顾性分析2017年3月—2022年9月聊城市人民医院收治的UTI患儿244例的临床资料,比较患儿细菌培养结果、合并症、病原菌种类分布与药敏结果分析。结果:送检样本中共分离到病原菌株140例,药敏结果显示,以革兰阴性杆菌为主,其中前5位的细菌分别为大肠埃希菌(占比67.2%)、肺炎克雷伯菌(占比8.6%)、屎肠球菌(占比7.9%)、粪肠球菌(占比5.0%)、奇异变形杆菌(占比2.1%)。杆菌属中大肠埃希菌居首位,对哌拉西林他唑巴坦、头孢哌酮舒巴坦敏感性较高,分别为93.6%、89.1%,对碳青霉烯类抗生素表现为100.0%敏感性;球菌属中屎肠球菌对氨苄西林及青霉素耐药性高于粪肠球菌,药物敏感性较低。结论:2017年3月—2022年9月聊城市人民医院收治的UTI患儿病原菌分布以革兰阴性杆菌为主,大肠埃希菌是最常见的致病菌,哌拉西林他唑巴坦的敏感性较高,可作为临床首选用药。同时,早期识别并合理应用敏感药物在临床首诊工作中至关重要,监测与定期分析本地区病原菌分布变化及抗菌药物耐药情况具有重大意义。

Objective:To analyze the distribution and drug resistance of pathogenic bacteria in children with urinary tract infection(UTI).Methods:Clinical data of two hundred and forty-four children with UTI admitted to Liaocheng People's Hospital from March 2017 to September 2022 were retrospectively analyzed,and bacterial culture results,comorbidities,pathogen species distribution and drug susceptibility analysis were compared.Results:A total of 140 pathogenic strains were isolated from the samples.The results of drug sensitivity showed that gram-negative bacilli were predominant.The top 5 bacteria were Escherichia coli(67.2%),Klebsiella pneumoniae(8.6%),Enterococcus faecium(7.9%),Enterococcus faecalis(5.0%)and Proteus mirabilis(2.1%).Eschericheria coli ranked the first in the genus of Bacillus,with high sensitivity to piperacillin tazobactam and cefoperazone sulbactam(93.6%and 89.1%,respectively),and 100.0%sensitivity to carbapenems.The resistance of Enterococcus faecium to ampicillin and penicillin was higher than that of Enterococcus faecalis,and the drug sensitivity was lower.Conclusion:Gram-negative bacteria were the main pathogenic bacteria in children with UTI treated in Liaocheng People's Hospital from March 2017 to September 2022,and Escherichia coli was the most common pathogenic bacteria.Piperacillin and tazobactam were highly sensitive and could be used as the preferred clinical drug.At the same time,early identification and reasonable application of sensitive drugs are crucial in the first clinical diagnosis,and it is of great significance to monitor and regularly analyze the changes in the distribution of pathogenic bacteria and the situation of antimicrobial resistance in this region.