| Objective: To investigate the clnical features and antibiotic resistance of children with urinary tract infection to improve the level of treatment.Methods: The clinical data of 365 cases of children with UTI who came from Children' s Hospital,Chongqing University of Medical Sciences were retrospectively analyzed. In order to know the clnical features,the distribution of pathogens,antibiotic resistance and the change of pathogen resistance in different groups, the cases were divided into different groups according to different ages, genders and basic diseases of the urinary systemResult:1. The gender distribution in children with urinary tract infection varied with age, the proportion of boys was higher in the cases of <3y,while the proportion of girls was higher in the cases of≥3y.2. Asymptomatic bacteriuria accounted for 59.18% ,and without distinction of age and sex.3. In the 365 cases, the cases of complicated urinary tract infection accounted for 76.16% (278) ,the main complicating factors were Nephrotic syndrome(20.96%), nephritis syndrome(14.43%) and hydronephrosis(14.09%). 29 cases had a relapse and 75.86% of these had complicating factors of urinary system.4. 29 cases of these had recurrent UTI,13 cases were relapse UTI, and 9 had a reinfection. These who had basis urinary system diseases accounted for 75.86%, The commonly diseases were urethral stricture, nephrotic syndrome, the stricture of the end of urethral.5. The rate of culture-positive of urine was 48.22% ,the Gram-positive bacteria accounted for 82.67%,Gram-n egative bacteria 13.33% ,while Fungi accounted for 4.00%.E.Coliwa was most commonly found (48.00%) in the Gram-positive bacteria. The proportion of Enterococcus which was the dominating pathogen in Gram-negative bacteria had an upward trend compared to that 10 years ago in the same area. The comparison of constitute of the major pathogens between the Unite sates and the region were significant different.6. E.Coliwa was sensitive to Amikacin, Tienam, piperacillin/Tazobactam, the rate was higer than 50%, Klebsiella pneumoniae subspecies pneumoniae was sensitive to Tienam, Merrem , Levofloxacin, the rate was higer than 55%. But Enterococcus feces was sensitive to Vancomycin, Linezolid.7.7 7Extended一speetrumbeta一Laetamase一produeing(ESBLs) bacteria were isolated from all the 144 bacteria,the detected rates of producing ESBLs E.Coliwa, Klebsiella pneumoniae were 70.83% and 77.78% .And they were both sensitive to Tienam,Amikacin, piperacillin/Tazobactam, the rate was higer than 50%.8 The most common pathogens in initial and recurrent UTI,NS with UTI,UTI with the basic diseases of urinary system was E.Coliwa ,and it was sensitive to Amikacin, Tienam, piperacillin/Tazobactam in all of them.9. Those who had B-ultrasound accounted for 47.42% ( 101/213 ),the diseases of hydronephrosis, urinary stones were the most common.Conclusion:1. The proportion of boys with urinary tract infection who were 3years younger was higher than that older than 3years,while in girls it was higher in the cases of <3y.2. Complicated urinary tract infections were found more common,the main complicating factors were Nephrotic syndrome, nephritis syndrome and hydronephrosis,and these children had a risk of relapse.3. Asymptomatic bacteriuria was more common in the children suffering Nephrotic syndrome complicated with urinary tract infection.4. The most common pathogen in initial and recurrent UTI,NS with UTI,UTI with the basic diseases of urinary system was E.Coliwa But the pathogens changes over the time and the constitute was significant different between different countries during the same time.The proportion of Gram-positive cocci was increasing5. E.Coliwa was sensitive to Amikacin mostly,and it also sensitive to Piperacillin/Tazobactam which could be used as experience-based medicine.6. The detected rates of producing ESBLs E.Coliwa, Klebsiella pneumoniae were increasing, The medicine shoud be adjusted according to the urine culture results in clinical treatment. |
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