Pathogen spectrum and drug resistance of urinary tract infections in 264 children in Zhengzhou
Objective To understand the distribution and drug resistance characteristics of pathogenic bacteria in chil-dren with urinary tract infections in Zhengzhou.Methods The medical history data of children with positive urine cul-ture in the Third Affiliated Hospital of Zhengzhou University from March 2018 to July 2023 were collected.The bacteria were identified and drug sensitivity tests were performed using an automated microbiological analyzer and paper disk dif-fusion method.Data analysis was conducted using SPSS software.Results A total of 264 cases of urinary tract infec-tions in children were collected,with 288 strains of isolated bacteria,including 219 strains of Gram-negative bacilli(76.04％),60 strains of Gram-positive cocci(20.83％),and 9 strains of Candida(3.13％).The top six pathogens isolated from urine cultures were Escherichia coli,Klebsiella pneumoniae,Enterococcus faecalis,Pseudomonas aerugi-nosa,Enterobacter cloacae complex,and Staphylococcus saprophyticus.There was a gender difference in the distribu-tion of Gram-positive cocci,with Enterococcus faecalis being predominant in male patients and Staphylococcus saprophyticus being predominant in female patients.Escherichia coli showed resistance rates above 75％to ampicillin/sulbactam,ceftriaxone,and ceftazidime.Klebsiella pneumoniae showed resistance rates above 60％to ceftazidime,ceftriaxone,amikacin,and ampicillin/sulbactam.Enterococcus faecalis showed resistance rates above 50％to tetracycline,erythro-mycin,levofloxacin,and high-concentration gentamicin.Staphylococcus saprophyticus showed resistance rates above 90％to penicillin,ciprofloxacin,levofloxacin,ampicillin/sulbactam,and erythromycin.The resistance rate of Esche-richia coli to ampicillin/sulbactam was higher in male patients than of female patients,and the resistance rate of Esche-richia coli to gentamicin was higher in patients over 1 year old than of those under 1 year old.In addition,Klebsiella pneumoniae showed a higher resistance rate to cefepime in patients under 1 year old.Conclusion Escherichia coli,Klebsiella pneumoniae,and Enterococcus faecalis are the main pathogens of urinary tract infections.There are differ-ences in the distribution and drug resistance of pathogens among children of different ages and genders.Hospital infec-tion testing should be conducted,urine cultures should be actively submitted for testing,and rational drug use should be based on drug sensitivity results.
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