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目的分析儿童尿路感染(UTI)患者基本临床特征、辅助诊断指标、细菌感染谱及耐药情况,旨在为儿童UTI的预防、诊断、治疗提供依据。方法收集2012年1月至2014年3月在西安市儿童医院诊断为UTI或合并UTI的住院患者临床资料,剔除重复菌株,综合分析复杂性UTI患者与非复杂性UTI患者致病菌的差异。结果儿童首次UTI发病高峰在0~0.5岁。大肠埃希菌、克雷伯菌属以及铜绿假单胞菌是儿童UTI的主要致病菌,其中大肠埃希菌110株,占52.9%。UTI肠杆菌科致病菌对碳青霉烯类抗菌药物有较高的敏感度,耐药率小于10%;其他所检测的抗菌药物耐药率均大于20%。结论该地区住院患儿UTI耐药率较高,在治疗儿童UTI时,应结合当地细菌耐药的情况及疾病的严重程度合理使用抗菌药物,避免细菌耐药加剧。
Objective To analyze the basic clinical features, auxiliary diagnostic indicators, bacterial infection spectrum and drug resistance in children with urinary tract infection (UTI), and to provide evidence for the prevention, diagnosis and treatment of UTI in children. Methods The clinical data of hospitalized patients diagnosed as UTI or combined UTI from January 2012 to March 2014 in Xi’an Children’s Hospital were collected. The duplicated strains were excluded and the differences of pathogenic bacteria in complicated UTI patients and non-complicated UTI patients were analyzed comprehensively. Results The first onset of UTI in children was between 0 and 0.5 years old. Escherichia coli, Klebsiella and Pseudomonas aeruginosa were the main pathogens of UTI in children, of which Escherichia coli 110, accounting for 52.9%. Enterobacteriaceae UTI Enterobacteriaceae carbapenems antibacterials have a higher sensitivity, resistance rate of less than 10%; other tested antibacterial drug resistance rates were greater than 20%. Conclusion The prevalence of UTI in hospitalized infants in this area is high. In the treatment of UTI in children, antimicrobial agents should be used reasonably in combination with local bacterial resistance and the severity of the disease so as to avoid aggravating bacterial resistance.