The Clinical Characteristics And Etiological Analysis Of 364 Children With Urinary Tract Infection

Objective To investigate the clinical characteristics,distribution of common pathogens and drug resistance of children with urinary tract infection in Jiaxing area.Methods Retrospectively analysed the clinical manifestation,urine culture,drug sensitivity test and other auxiliary examination data of 364 children mainly diagnosed with urinary tract infection admitted to the pediatric ward of our hospital from January 2017 to November 2022.The data were analyzed using GraphPadPrism 9.0 statistical software.Results 1 Among the 364 patients,the minimum age was lm,the maximum was 13 years old and the median age was 2 years old.There were 122 males(33.52%)and 242 females(66.48%),with a male to female ratio of 1:1.98.2.The most common symptoms in children with urinary tract infection were respiratory tract symptoms in 61 cases(52.14%)and digestive tract symptoms in 24 cases(20.51%).3.Urine routine pH values were<6.02 at 2 years old and 6.27 at ≥2 years old,P<0.05.There was no significant difference in pH among Escherichia coli,Klebsiella pneumoniae,Enterococcus faecium and Enterococcus faecalis(P>0.05).4.In 362 cases,191 pathogens were detected in urine culture(detection rate 52.49%).There were 162 cases of GNB(84.82%),mainly Escherichia coli,among which 46.09%were ESBLs-producers.There were 29 cases(15.18%)of GPB,mainly Enterococcus faecium and Enterococcus faecalis.The proportion of GPB in male children was higher than GNB,the number of white blood cells was lower than GNB,the fever symptoms were relatively less,and the abnormal ultrasound of urinary system was more common in GPB group(P<0.05).There was no significant difference between the proportion of drug-resistant strains during Covid-19 pandemic and before(P>0.05).5.The drug resistance rate of Escherichia coli to Ampicillin and Piperacillin were more than 80%,and were highly sensitive to Furantoin,Imipenem,Meropenem,Piperacillin/Tazobactam,Cefoperazone/Sulbactam and other antibiotics with β-lactamase inhibitors(resistance rate<5%).The resistance rate of ESBLs-producing Eschericcoli to Cefazolin,Ceftriaxone and Amtrannan were significantly higher(>60%).The resistance rate of Enterococcus faecium to Penicillin G,Ampicillin,Erythromycin,Clindamycin,Tetracycline,high concentration of Gentamicin and Ciprofloxacin were above 60%,and they were sensitive to Furantoin,Linezolid,Vancomycin,Tegacycline and Quinuputin/Dafotene.Conclusion The clinical manifestations of urinary tract infection in children vary from age to age,and fever is the main manifestation in infants.Escherichia coli is still the most common pathogen,and the detection rate of ESBL-producing Escherichia coli,Klebsiella pneumoniae and other drug-resistant strains is high.Abnormal urinary ultrasound,antibiotic use in the last 90 days,and hospitalization in the last 30 days may be the risk factors for ESBLs strain.