| 宋培培,张 琴,许 健,王 秦,刘成桂.某三甲医院儿童和成年女性尿培养病原菌分布和耐药性分析[J].,2021,(12):2344-2349 |
| 某三甲医院儿童和成年女性尿培养病原菌分布和耐药性分析 |
| Distribution and Drug Resistance of Pathogenic Bacteria Isolated from Urine Culture of Children and Adult Women in a Tertiary Hospital |
| 投稿时间：2020-09-23 修订日期：2020-10-17 |
| DOI：10.13241/j.cnki.pmb.2021.12.032 |
| 中文关键词: 尿培养 成年女性 儿童 病原菌 耐药性 |
| 英文关键词: Urine culture Adult women Children Pathogen Drug resistance |
| 基金项目:四川省科技计划重点研发项目（2020YFS0494）；成都市科技惠民技术研发项目（2015-HM01-00623-SF） |
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| 中文摘要: |
| 摘要 目的：了解尿路感染儿童和成年女性尿培养病原菌种类和耐药性的差异，为临床合理选用抗菌药物提供依据。方法：分别收集2018年1月~2019年12月期间在我院住院的尿路感染儿童的尿培养标本1618份和尿路感染成年女性的尿培养标本1044份，分析其病原菌的分布和耐药性。结果：1618份儿童尿培养标本中分离出267株病原菌，居首位的病原菌是屎肠球菌，占43.82%（117/267）；1044份成年女性尿培养标本中分离出139株病原菌，居首位的病原菌是粪肠球菌，占28.78%（40/139）。在两种人群尿培养病原菌中大肠埃希菌和肺炎克雷伯菌构成比均分别为第二位和第三位。儿童尿培养屎肠球菌对青霉素G、氨苄西林、环丙沙星等喹诺酮类药物的耐药率高于成年女性尿培养粪肠球菌，对克林霉素、奎奴普丁/达福普汀、四环素的耐药率低于成年女性尿培养粪肠球菌（P＜0.05）；未发现对高浓度庆大霉素、高浓度链霉素、利奈唑胺、万古霉素、替加环素耐药的肠球菌。儿童尿培养大肠埃希菌对氨苄西林/舒巴坦、头孢吡肟的耐药率均高于成年女性尿培养大肠埃希菌（P＜0.05）。儿童尿培养肺炎克雷伯菌对头孢哌酮/舒巴坦、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、氨曲南、厄他培南、亚胺培南、美洛培南、呋喃妥因、头孢唑啉等头孢菌素类药物的耐药率高于成年女性尿培养肺炎克雷伯菌（P＜0.05）。结论：尿路感染儿童和成年女性尿培养病原菌均以肠球菌为主，大肠埃希菌和肺炎克雷伯菌构成比分别为第二位和第三位，两种人群尿培养主要病原菌耐药性均有不同程度的差异，临床医生应根据尿培养和药敏结果合理用药。 |
| 英文摘要: |
| ABSTRACT Objective: To understand the differences in the types and drug resistance of pathogenic bacteria in urine culture between children and adult women with urinary tract infection, so as to provide basis for rational selection of antimicrobial agents in clinical practice. Methods: A total of 1618 urine culture specimens of children with urinary tract infection and 1044 urine culture specimens of adult women with urinary tract infection were collected from January 2018 to December 2019 in our hospital respectively, to analyze the distribution and drug resistance of their pathogenic bacteria. Results: Among the 1618 urine culture specimens of children, 267 strains of pathogenic bacteria were isolated and enterococcus faecalis was the first pathogenic bacteria, accounting for 43.82%(117/267). 139 strains of pathogenic bacteria were isolated from 1044 adult female urine culture specimens and enterococcus faecalis was the leading pathogenic bacteria, accounting for 28.78%(40/139). The composition ratios of Escherichia coli and Klebsiella pneumoniae were the second and the third respectively in the two kinds of human pathogenic bacteria cultured in urine. The drug resistance rate of enterococcus faecalis in urine culture of children to quinolones such as penicillin G, ampicillin and ciprofloxacin was higher than that in urine culture of adult women, the drug resistance rate of clindamycin, quinuptin/dafoptin and tetracycline was lower than that of enterococcus faecium in adult female urine culture(P<0.05). Enterococci with high concentrations of gentamicin, streptomycin, linezolid, vancomycin and tegacycline were not found. The drug resistance rate of escherichia coli in urine culture of children to ampicillin/sulbactam and cefepime was higher than that in urine culture of adult women(P<0.05). The drug resistance rate of klebsiella pneumoniae in urine culture of children to cephalosporin drugs such as cefoperazone/sulbactam, ampicillin/sulbactam, piperacillin/tazobactam, amitapenan, imipenem, meropenem, furantoin and cefazolin were higher than that of adult female klebsiella pneumoniae(P<0.05). Conclusion: Enterococci is the main pathogenic bacteria in urine culture of children and adult female with urinary tract infection, the composition ratios of escherichia coli and klebsiella pneumoniae are second and third respectively, the drug resistance of the two main pathogenic bacteria in human urine culture is different in different degrees, the clinician should rationally use the drug according to the results of urine culture and drug sensitivity. |
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