摘要
目的 分析尿路结石合并感染患儿的尿病原微生物及药敏试验,探讨小儿尿路结石发病与尿路感染的相关性.方法 选取2018年10月至2019年11月在新疆维吾尔自治区人民医院儿保门诊就诊的100例正常小儿(＜14岁)的尿液样本为对照组,选取泌尿中心住院治疗的100例尿路结石患儿的尿液样本为病例组,均行尿液常规检查及其耐药情况检测,分析患儿尿液中的细菌分布情况.结果 病例组的男性所占比例、尿常规、尿细菌培养、血常规血清白细胞、C反应蛋白(CRP)阳性率均高于对照组(均P＜0.05)o logistic回归分析结果显示,尿常规、细菌培养、血清白细胞、CRP等感染指标均与尿路结石有关(均P＜0.05),且感染是尿路结石的危险因素(OR＞1).通过logistic回归建立预测模型,结果显示性别、血清白细胞阳性、CRP阳性、尿常规阳性为患尿路结石的有效预测因子,预测模型的受试者工作特征(ROC)曲线的曲线下面积为0.879(95％CI:0.829～0.928),cut off值为26.61％.在病例组中,尿路感染61例,共检测出20例菌株,其中革兰阳性菌为7株(35％),革兰阴性菌为13株(65％);革兰阳性菌对四环素、左氧氟沙星等抗生素耐药性较低;革兰阴性菌对亚胺培南、哌拉西林/他唑巴坦、美罗培南、头孢他啶等抗生素耐药性较低.结论 尿路结石患儿合并尿路感染率较正常儿童高,大肠埃希菌感染是导致本院尿路结石患儿尿路感染的主要病原微生物;革兰阳性菌对四环素、左氧氟沙星等抗生素耐药性较低;革兰阴性菌对亚胺培南、哌拉西林/他唑巴坦、美罗培南、头孢他啶等抗生素耐药性较低.
Abstract
Objective To analyze the results of pathogenic microorganism and drug sensitivity test in children with urinary calculi complicated with infection,and to explore the correlation between the incidence of urinary calculi and urinary tract infection in children.Methods Urine samples were collected from 100 normal children(under 14 years old)hospitalized in the Child Care Clinic of Peo-ple's Hospital of Xinjiang Uygur Autonomous Region from October 2018 to November 2019 as the con-trol group,and urine samples from 100 children hospitalized in the Urological Center of People's Hos-pital of Xinjiang Uygur Autonomous Region as the case group.Urine routine examination and drug re-sistance detection were performed to analyze the distribution of fine bacteria in the urine of the chil-dren.Results The proportion of male in the case group was higher than that in the control group,and the positive rates of urine routine,urine bacterial culture,blood routine serum white blood cell,CRP and other indicators in the case group were higher than those in the control group,with statistically sig-nificant differences between the two groups(all P＜0.05).Logistic regression analysis of infection in-dicators showed that urinary routine,bacterial culture,serum white blood cell,CRP and other infec-tion indicators were related to urinary calculi(all P＜0.05),and positive infection indicators were risk factors for urinary calculi(OR＞1).The predictive model was established by logistic regression,and the results showed that gender,serum leukocyte positive,CRP positive,and urine routine positive were effective predictors of urinary calculi.The area under the ROC curve of the predictive model was 0.879(95％CI:0.829-0.928),the cut off value was 26.61％.In the case group,61 cases of urina-ry tract infection,a total of 20 strains were detected,of which 7 strains(35％)were gram-positive and 13 strains(65％)were gram-negative.The resistance to tetracycline,levofloxacin and other antibiot-ics was low in gram-positive ingot.The resistance to imipenem,piperacillin/tazobactam,meropenem,ceftazidime and other antibiotics was low.Conclusions Urinary tract infection rate in children with u-rinary calculus is higher than that in normal children.Escherichia coli infection is the main pathogenic microorganism leading to urinary tract infection in children with urinary calculi in our hospital.Gram-positive strains had low resistance to tetracycline,levofloxacin and other antibiotics.Gram-negative bacteria had low resistance to antibiotics such as imipenem,piperacillin/tazobactam,meropenem and ceftazidime.In order to obtain better curative effect.
基金项目
新疆维吾尔自治区人民医院院内科研项目(20170213)
NETL
NSTL
维普
万方数据