儿童泌尿道感染591例临床特点及病原菌分析

Clinical characteristics and pathogens analysis of 591 children with urinary tract infection

本研究旨在分析儿童泌尿道感染(urinary tract infection,UTI)的临床特点、病原菌构成、变迁及药敏试验结果,来帮助儿科医师更好地管理儿童UTI。通过收集2014年1月-2021年12月591例UTI住院患儿的临床资料,分析其临床特点和病原菌。结果显示:在不同的年龄组,男女发病率、临床症状、合并疾病的差异分别具有统计学意义(P<0.05)。常见病原菌主要为大肠埃希菌、屎肠球菌。2014-2017年度和2018-2021年度病原菌构成比的差异具有统计学意义(P<0.05)。近年来,大肠埃希菌的产酶率下降,产酶菌株有更高的耐药率,部分抗生素的耐药率下降。屎肠球菌对庆大霉素、左氧氟沙星等的耐药率均高于50%,而对达托霉素、呋喃妥因等的敏感率高于60%。本研究表明,儿童UTI的男女发病率、临床症状、合并的疾病随年龄不同而有差异。近年来,革兰氏阴性菌的占比呈上升趋势,而革兰氏阳性菌的占比呈下降趋势,大肠埃希菌的产酶率有所下降。产酶大肠埃希菌和屎肠球菌对多种常用抗生素耐药。

To analyze the clinical characteristics,pathogens and drug sensitivity of children urinary tract infection(UTI),so as to help pediatricians better manage UTI in children,clinical data of 591 hospitalized children with UTI from January,2014 to February,2021 were collected and analyzed.The results showed that the incidence of male and female,clinical manifestations and co-exist diseases were statistically significant in different age groups(P<0.05).The common pathogens were mainly E.coli and Enterococcus faecium.The proportion of pathogens in 2014-2017 and 2018-2021 was statistically significant(P<0.05).The enzyme-producing rate of E.coli decreased during 2018 and 2021,and the enzyme-producing strains showed higher drug resistance rate than the non-enzyme-producing strains,and the resistance rate of some antimicrobials decreased in recent years.The drug resistance rate of Enterococcus faecium to gentamycin and levofloxacin was higher than 50%,and the sensitivity rate to daptomycin and macrodantin was higher than 60%.It was concluded that the incidence,clinical manifestations and co-exist diseases in children with UTI varied with ages.In recent years,the proportion of gram-negative bacteria show an upward trend,while the proportion of gram-positive bacteria show a downward trend,andβlactamase-producing E.coli and Enterococcus faecium are resistant to many commonly used antibiotics.