儿童泌尿系感染病原菌分布及耐药性10 年变迁

临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (6): 525-.doi: 10.3969 j.issn.1000-3606.2015.06.006

• 泌尿系统疾病专栏 • 上一篇    下一篇

儿童泌尿系感染病原菌分布及耐药性10 年变迁


  1. 广州市妇女儿童医疗中心儿童院区肾内科( 广东广州 510120)
  • 收稿日期:2015-06-15 出版日期:2015-06-15 发布日期:2015-06-15
  • 通讯作者: 陈椰

The changes of pathogens distribution and antimicrobial resistance in children with urinary tract infection in 10 years

CHEN Ye, XIE Yongqiang, WEI Qing, LI Yingjie, GAO Yan   

  1. Department of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou 510120, Guangdong, China
  • Received:2015-06-15 Online:2015-06-15 Published:2015-06-15

摘要: 目的 了解近10年间广州市儿童医院泌尿系感染患儿病原菌的分布及耐药性变迁。方法 回顾性分析我院2001—2003年、2011—2013年泌尿系感染患儿尿培养及药敏试验结果。结果 近10年间革兰阴性菌与阳性菌的比例无明显变化,大肠埃希菌仍是引起儿童泌尿系感染的主要细菌;2011—2013年肠球菌的检出率为18.3%,较2001—2003年(7.5%)增多,差异有统计学意义(P<0.01),已成为第二位致病菌。产ESBLs菌株的分离率,2011—2013较2001—2003明显增高,差异有统计学意义(P<0.01)。近10年间大肠埃希菌对亚胺培南的敏感率一直保持在100%,对加酶抑制剂抗生素和呋喃妥因亦有较好的敏感性。不同种属的肠球菌对抗生素的敏感性不同。结论 儿童泌尿系感染病原菌的分布和耐药性在不断变化,应密切关注本地区及本院流行病学变化,合理应用抗菌药物。

Abstract: Objective To investigate the changes of pathogens distribution and antimicrobial resistance in children with urinary tract infection (UTI) in 10 years. Methods The results of urine culture and drug sensitivity in children with UTI from January 2001 to December 2003, and from January 2011 to December 2013 were retrospectively analyzed.Results In recent 10 years, there was no obvious change in the ratio of gram-negative bacteria to gram-positive bacteria. Escherichia coli was still the main bacteria causing UTI in children. The detection rate of enterococcus was significantly increased from 18.3% in 2011-2013 to 7.5% in 2001-2003 (P<0.05) and it had become the second pathogenic bacteria. The isolation rate of ESBLs producing strains was significantly higher in 2011-2013 than in 2001-2003 (P<0.05). The rate of Escherichia coli sensitive to imipenem remained at 100% and it is also sensitive to enzyme inhibitors antibiotics and nitrofuranto. Sensitivities to antibiotics were changed in different species of enterococcus. Conclusions The distribution of pathogens and antimicrobial resistance in children with UTI are constantly changing. The clinician should pay close attention to changes of epidemiology in the region and hospital and rational use of antimicrobial drugs.