摘要
目的探讨近8年小儿尿路感染病原菌分布及药敏变迁。方法收集医院2000—2007年门诊及住院患儿经尿培养确诊为尿路感染者391例，对其临床资料进行回顾性研究。结果共检出菌株402株，以G^-杆菌为主，占72．9％，埃希菌属最多见（34．4％），G^＋球菌占27．1％，主要是葡萄球菌属（12．9％）和肠球菌属（10．4％），其中埃希菌属、克雷伯菌属和肠球菌属感染比例逐年上升；G^-杆菌对氨苄西林、一～四代头孢耐药率高，对哌拉西林／他唑巴坦耐药率低，G^＋球菌对氨苄西林和红霉素耐药率高，对呋喃坦啶和万古霉素耐药率低；8年来大部分抗菌药物耐药性增高，尤以氨苄西林和头孢菌素类药物突出，而哌拉西林／他唑巴坦和万古霉素活性一直较强。结论小儿尿路感染病原菌以G^-杆菌为主，G^＋球菌有增加趋势，氨苄西林已不能作为首选用药，应及时监测病原菌变化及耐药趋势以合理用药。
OBJECTIVE To investigate the distribution, epidemic trend and transition of drugsr sensitivity about the pathogenic bacteria of children＇s urinary tract infection（UTI） in the past 8 years in the local area. METHODS The medical records of 391 UTI cases which were hospitalized in our hospital and confirmed as UTI through urine culture from 2000 to 2007, were reviewed and the clinical features were analyzed. RESULTS A total of 402 pathogenic bacteria were determined. Gram-negative bacilli were predominant, accounted for 72.9M, and Escherichia were the most commonly found（34.4 %）. Gram positive cocci accounted for 27.1%, including 12.9% of Staphylococcus and 10.4% of Enterococcus. The proportion of Escherichia, Klebsiella and Enterococcus was increased year by year. Gram-negative bacilli had a high resistance rate to ampicillin and 1st to 4th generation cefalosporins and a low resistance rate to piperacillin/tazobactam. Gram-positive cocci had a high resistance rate to ampicillin and erythromycin and a low resistance rate to nitrofurantoin and vancomycin. In the past 8 years, the resistance rate to most of the antibacterial agents has been increased, especially ampicillin and cephalosporins. Only piperacillin/tazobactam and vancomycin maintained high antibacterial activities. CONCLUSIONS Gram-negative bacilli are the major pathogens in pediatric UTI, and Gram-positive cocci appear to be increasing. Ampieillin should not to be chosen commonly. The observation of variation of pathogenic bacteria and drug resistance is of great importance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第16期2199-2202,共4页
Chinese Journal of Nosocomiology
关键词
患儿
尿路感染
病原菌
药敏试验
Children
Urinary tract infection
Pathogenic bacteria
Examination of drug＇s sensitivity
