儿童神经源性膀胱尿路感染常见病原菌及药物敏感性分析

Analysis of common pathogens and drug sensitivity of neurogenic bladder urinary tract infection in children

目的 分析儿童神经源性膀胱尿路感染常见病原菌及药物敏感性。方法 回顾性选取2019年1月—2020年12月苏州大学附属儿童医院收治的164例神经源性膀胱尿路感染患儿资料和437例非神经源性膀胱尿路感染患儿资料,分析病原菌组成及药物敏感性的差异。结果 神经源性膀胱组患儿共检出202株致病菌,其中常见致病菌为大肠埃希菌95株(47.03%),肺炎克雷伯杆菌21株(10.40%);非神经源性膀胱组患儿共检出437株致病菌,其中常见致病菌为大肠埃希菌266株(60.87%),肺炎克雷伯杆菌29株(6.64%);2组间主要致病菌构成比比较差异有统计学意义(P<0.05);主要致病菌的耐药性方面,神经源性膀胱组患儿检出大肠埃希菌多重耐药菌株58株(58/95,61.05%),肺炎克雷伯杆菌耐药菌株7株(7/21,33.33%);非神经源性膀胱组检出大肠埃希菌耐药菌株31株(31/266,11.65%),肺炎克雷伯杆菌耐药菌株3株(3/29,10.34%);神经源性膀胱组患儿更易发生多重耐药大肠埃希菌感染。结论 神经源性膀胱患儿较非神经源性膀胱患儿更易发生非大肠埃希菌尿路感染,且多重耐药菌株比例更高,需选择高级别敏感抗生素治疗。

Objective Analyze the common pathogens and drug sensitivity of neurogenic bladder urinary tract infection in children.Methods Retrospective selection of 164 children with neurogenic bladder urinary tract infection and 437 children with non neurogenic bladder urinary tract infection admitted to Children′s Hospital of Soochow University from January 2019 to December 2020 was conducted to analyze the differences in pathogen composition and drug sensitivity.Results A total of 202 strains of pathogenic bacteria were detected in children with neurogenic bladder,of which 95 strains(47.03%)of Escherichia coli and 21 strains(10.40%)of Klebsiella pneumoniae were common pathogenic bacteria;A total of 437 strains of pathogenic bacteria were detected in children with non neurogenic bladder,among which 266 strains(60.87%)of Escherichia coli and 29 strains(6.64%)of Klebsiella pneumoniae were common pathogenic bacteria;There was a statistically significant difference in the proportion of major pathogenic bacteria between the two groups(P<0.05);In terms of drug resistance of the main pathogenic bacteria,58 strains(58/95,61.05%)of Escherichia coli multidrug-resistant strains and 7 strains(7/21,33.33%)of Klebsiella pneumoniae were detected in children with neurogenic bladder;31 Escherichia coli resistant strains(31/266,11.65%)and 3 Klebsiella pneumoniae resistant strains(3/29,10.34%)were detected in the non neurogenic bladder group;Children with neurogenic bladder are more likely to develop multidrug-resistant Escherichia coli infection.Conclusion Children with neurogenic bladder are more likely to develop non Escherichia coli urinary tract infections than those with non neurogenic bladder,and the proportion of multidrug-resistant strains is higher,requiring the selection of advanced sensitive antibiotics for treatment.