Changes of pathogens in children with urinary tract infection in a single center in Beijing / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the changes of distribution and antimicrobial resistance of pathogens in children with urinary tract infection in a single center in Beijing, and to provide references for the rational use of antibio-tics agent in clinical practice.Methods:The clinical data as well as urine culture and drug sensitivity results of children with urinary tract infection treated in the Department of Nephrology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2013 to May 2018 were retrospectively analyzed.According to the time of onset, the patients were divided into 2 groups, namely the 2013 to 2015 group and the 2016 to 2018 group.SPSS 17.0 software was used for statistical analysis of clinical data.Results:Among the 744 pathogenic bacteria isolated, the most common type was Gram-negative bacteria (59.4%, 442/744 strains), and the proportion of Escherichia coli ( E.coli) was the highest (39.4%, 293/744 strains). Gram-positive bacteria were the second most common (36.8%, 274/744 strains), among which, Enterococcus faecium (21.8%, 162/744 strains) accounted for the largest proportion (3.8%, 28/744 strains). Fungi were the least common type of pathogenic bacteria (3.8%, 28/744 strains). In Gram-negative bacteria, E.coli was highly resistant to Ampicillin (87.6%, 255/291 strains), but less resistant to Piperacillin/Tazobactam (12.7%, 37/291 strains). By comparing the overall distribution of Gram-positive, Gram-negative and common pathogenic bacteria in 2013 to 2015 and 2016 to 2018, the infection rate of Gram-negative bacteria (63.8%, 55.5%)was always higher than that of Gram-positive bacteria(33.1%, 40.2%), but the infection rate of Gram-positive bacteria has shown an upward trend in recent years, and the differences were statistically significant ( χ2=4.080, P<0.05). Conclusions:The main pathogenic bacteria of urinary tract infection in children are Gram-negative bacteria, and E.coli is the most common causative bacteria.However, the infection rate of Gram-positive bacteria has been increasing in recent years. E.coli is highly sensitive to Piperacillin and Tazobactam, which can be used as the adequate selection for treating urinary tract infection in children. E.coli is highly resistant to the first and the second-generation cephalosporin antibiotics, but sensitive to the third-generation cephalosporin antibiotics, such as Cefotetan.