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婴儿泌尿道感染的病原菌分布及耐药性分析
引用本文:李基明,张慧芬,吴健宁,谢辉. 婴儿泌尿道感染的病原菌分布及耐药性分析[J]. 中国微生态学杂志, 2013, 0(11): 1327-1329,1359
作者姓名:李基明  张慧芬  吴健宁  谢辉
作者单位:[1]厦门市妇幼保健院医学检验科,福建厦门361003 [2]厦门市妇幼保健院儿内科,福建厦门361003
摘    要:目的探讨婴儿泌尿道感染的病原菌构成及其耐药情况,以指导临床合理用药。方法对2012年5月至2013年7月某院门诊及住院婴儿送检的尿标本进行分离培养,用全自动微生物鉴定/药敏系统进行菌种鉴定和药敏试验,同时对大肠埃希菌和肺炎克雷伯菌进行超广谱β-内酰胺酶检测。结果婴儿泌尿道感染以大肠埃希菌检出率最高(46.24%),其余依次是粪肠球菌(22.04%)、肺炎克雷伯菌(7.80%)、屎肠球菌(5.37%)、铜绿假单胞菌(4.30%)。大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶检出率分别为46.51%和58.62%。革兰阴性菌对亚胺培南、美罗培南的耐药率为0,对氨苄西林耐药率最高(〉80%)。革兰阳性菌对万古霉素耐药率为0,对苯唑西林、妥布霉素的耐药率100%。结论婴儿泌尿道感染病原菌以大肠埃希菌为主;大肠埃希菌、肺炎克雷伯菌超广谱β-内酰胺酶检出率高,应引起重视;临床医师要根据药敏结果指导用药,对危重病例和存在泌尿道畸形反复发作病例,革兰阴性菌可选用亚胺培南、美罗培南,革兰阳性菌可选用万古霉素。

关 键 词:婴儿  泌尿道感染  病原菌  耐药性

Distribution and resistance of pathogens causing urinary tract infections in infant
LI Ji-ming,ZHANG Hui-fen,WU Jtan-ming,XIE Hui. Distribution and resistance of pathogens causing urinary tract infections in infant[J]. Chinese Journal of Microecology, 2013, 0(11): 1327-1329,1359
Authors:LI Ji-ming  ZHANG Hui-fen  WU Jtan-ming  XIE Hui
Affiliation:1. Department of Clinic Laboratory; 2. Pediatrics ,Xiamen Maternal and Children' s Hospital ,Xia- men 361003, China
Abstract:Objective To examine distribution and resistance of pathogens causing urinary tract infections to decide on the strategy of elinieal treatment. Methods Bacteriuria in infants from Xiamen Maternal and Children' s Hospital from May 2012 to July 2013 were isolated, cultured and analyzed by automated mierobiology system. Of which, Escheriehia coli and KlebsieUa pneumonia were detected by Extended-spectrum beta-lactamase (ESBL) test. Results Escherichia coli was the predominant pathogen with highest positive rate in urinary tract infections (46.24%). The next four pathogens with higher positive rate were E. faecalis (22.04%), Klebsiella pneumoniae (7.80%) ,Enterococcus faecium(5.37% ) and P. Aeruginosa(4.30% ). The positive rate of ESBL test for Esehe- richia eoli and Klebsiella pneumonia were 46.51% and 58.62%, respectively. Drug sensitivity test presented that Gram-positive bacteria were sensitive to Imipenem or Meropenem but resistant to Ampicillins ( 〉 80% ) ; Gram- negative bacteria showed sensitivity to Vancomycin and resistance to Oxacillin or Tobramycine (100%). Conclusion Escherichia eoli is the predominant pathogen causing urinary tract infections; ESBL test is effective in detecting Eseherichia coli and Klebsiella pneumoni ; Clinicians should use drugs according to result of drug sensitivity test. For severe and repeat infection cases, Imipenem and/or Meropenem could be used for Gram-positive bacterial infeetion while Vaneomycin for Gram-negative bacterial infeetion.
Keywords:Infant  Urinary tract infections  Pathogen  Drug resistance
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