OBJECTIVE: To investigate the distribution and antibiotic resistance of pathogens isolated from children with complicated urinary tract infection. METHODS: A retrospective analysis was performed on the distribution and antibiotic resistance of pathogens isolated from 181 children with complicated urinary tract infection (positive urine culture). The antibiotic resistance of common pathogens was determined by the antimicrobial susceptibility test. RESULTS: Gram-negative bacilli were the main pathogens (63.5%), and involved Escherichia coli (E.coli) of 42.0%. Gram-positive cocci accounted for 32.1%, and involved enterococci faecalis of 15.5%. Fungi infection was found in 4.4% of children. The resistance rate of E.coli to ampicillin was the highest (89.4%), but the rate decreased significantly by adding amoxicillin/clavulanic acid (34.2%). E.coli had a high resistance rate to cephazolin, ceftriaxone and cafalotin (>50%), but the resistance rate of E.coli to cefoperazone/sulbouam was significantly lower than other cephalosporins (P<0.01). E.coli was sensitive to imipenem and displayed a lower resistance rate to furadantin (<10%). The resistance rate of enterococci faecalis to rifampicin was high (78.3%), but was low to furadantin, vancomycin and linezolid (<10%). The multiresistant strains accounted for 77.4% of gram-negative bacilli. CONCLUSIONS: E.coli is the major pathogen in children with complicated urinary tract infection, and the enterococci-caused urinary tract infection has been increasing. These pathogens have a high antibiotic resistance, and most of them are multiresistant. Antimicrobial therapy should be based on the results of urine culture and antimicrobial susceptibility test.
Key words
Urinary tract infection /
Pathogen /
Antibiotic resistance /
Child
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References
［1］Lichtenberger P,Hooton TM.Complicated urinary tract infections［J］.Curr Infect Dis Rep, 2008, 10(6): 499-504.
［2］Reyes L, Alvarez S, Allam A, Reinhard M, Brown MB. Complicated urinary tract infection is associated with uroepithelial expression of proinflammatory protein S100A8［J］.Infect Immun, 2009, 77(10): 4265-4274.
［3］Mahesh E, Ramesh D, Indumathi VA, Punith K, Raj K, Anupama HA. Complicated urinary tract infection in a Tertiary Care Center in South India［J］.AI Ameen J Med Sci, 2010, 3(2): 120-127.
［4］李雪梅,毛元英,尉冬英. 复杂性尿路感染238例致病菌及耐药性分析［J］.现代临床医学,2008,34(1):33-34.
［5］叶任高，宋青.泌尿系感染及反流性肾病［M］//王海燕.肾脏病学.第2版.北京:人民卫生出版社,1996:801-824.
［6］杨霁云.泌尿系感染［M］//杨霁云，白克敏.小儿肾脏病基础与临床.北京：人民卫生出版社，2001：351-355.
［7］刘延霞,杨青，林瑞霞.小儿尿路感染及膀胱输尿管反流［J］.中国当代儿科杂志,2008,10(1)：83-84.
［8］高晓洁,李永柏,赵维玲,杨军,马祖祥,王凯,等.儿童泌尿系感染的临床特点、病原菌分布及耐药性分析［J］.实用儿科临床杂志，2010,25(5):330-332.
［9］Rodríguez Ba~no J, Alcal-J, Cisneros JM, Grill F, Oliver A, Horcajada JP, et al. Escherichia coli producing SHV-type extended spectrum beta-lactamase is a significant cause of community-acquired infection［J］.J Antimicrob Chemother, 2009, 63(4): 781-784.
［10］Marcadé G, Deschamps C, Boyd A, Gautier V, Picard B, Branger C, et al. Replicon typing of plasmids in Escherichia coli producing extended-spectrum beta-lactamases［J］.J Antimicrob Chemother, 2009, 63(1): 67-71.
［11］廖伟，赵聪敏，温恩懿，张雨平，王丽雁，何周梅，等.阿莫西林克拉维酸钾干混悬剂口服治疗小儿泌尿系感染临床观察［J］.中国实用儿科杂志，2010,25(6):475-477.
［12］Taneja N, Rao P, Arora J, Dogar A. Occurrence of ESBL ＆ Amp-C beta-lactamases ＆ susceptibility to newer antimicrobial agents in complicated UTI［J］. Indian J Med Res, 2008, 127(1): 85-88.
［13］Svetitsky S, Leibovici L, Paul M. Comparative efficacy and safety of vancomycin versus teicoplainin: systematic review and meta-analysis［J］. Antimicrob Agents Chemother, 2009, 53(10): 4069-4079.
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