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目的分析本院近年肾病综合征合并泌尿系统感染患儿病原菌分布及药敏状况,为本院临床治疗儿童肾病综合征合并泌尿系统感染经验用药提供参考依据。方法统计分析2009年1月-2014年9月本院儿科收治的45例肾病综合征合并泌尿系感染患儿中段尿培养菌株鉴定及药敏试验结果。结果本组45例肾病综合征合并泌尿系统感染患儿,中段尿培养菌株鉴定出病原菌48株,其中革兰氏阴性菌43株,革兰氏阳性菌5株,所占病原菌比例分别为89.5%和10.4%。主要的病原菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌。氨苄青霉素、头孢他啶、头孢曲松的耐药率较高,均>50%。头孢哌酮/舒巴坦,亚胺培南,美罗培南的耐药率较低。结论对于肾病综合征合并泌尿系统感染患儿,头孢哌酮/舒巴坦以其高度敏感性及适宜的价格,推荐为经验用药的首选。
Objective To analyze the distribution and drug susceptibility of pathogenic bacteria in children with nephrotic syndrome and urinary tract infection in our hospital in recent years and provide reference for the clinical treatment of children with nephrotic syndrome and urinary tract infection. Methods Statistical analysis of 45 urinary nephropathy patients with nephrotic syndrome and urinary tract infection from January 2009 to September 2014 in our hospital was performed to identify urinary culture strains and drug susceptibility test results. Results The group of 45 cases of nephrotic syndrome with urinary tract infection in children, the middle of urinary culture identified 48 strains of pathogens, of which 43 Gram-negative bacteria, Gram-positive bacteria, accounting for the proportion of pathogens were 89.5% And 10.4%. The main pathogens are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa. Ampicillin, ceftazidime, ceftriaxone higher resistance rates were> 50%. Cefoperazone / sulbactam, imipenem and meropenem had lower resistance rate. Conclusion For children with nephrotic syndrome and urinary tract infection, cefoperazone / sulbactam is recommended as the first choice of empirical medicine because of its high sensitivity and suitable price.