一项关于尿路感染的儿科患者多药耐药性的观察性研究
Garzain Bint E Attar1, Shaista Ahmed1, Neetu Shree2
1Department of Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, 110062, India.
Naunyn-Schmiedeberg's archives of pharmacology
|November 28, 2025
概括
儿童尿路感染 (UTI) 很常见,大肠杆菌是主要的原因. 抗菌素耐药性 (AMR) 的上升需要仔细选择抗生素,因为许多常见药物对儿科尿路感染无效.
科学领域:
- 儿童传染病 儿童传染病
- 临床微生物学 临床微生物学
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 儿童尿路感染 (UTI) 是儿童发病的重要原因之一.
- 大肠杆菌是主要的病原体,但抗菌素耐药性 (AMR) 的增加使治疗复杂化,特别是在资源有限的环境中.
- 关于儿科尿路感染中AMR模式的数据往往很少,这阻碍了有效的管理.
研究的目的:
- 调查导致儿童尿路感染的尿病原体的患病率.
- 确定常见泌尿病原体的抗微生物敏感性模式.
- 评估儿科尿路感染单独体中的多药耐药性 (MDR) 的程度.
主要方法:
- 一项为期6个月的横截面研究,涉及80名儿童 (<18岁) 患有培养确认的尿路感染.
- 使用标准生化和自动化方法识别尿病原体.
- 通过VITEK 2和磁盘扩散 (CLSI指南) 进行抗菌敏感性测试;MDR定义为对≥3类≥1种药物的耐药性.
主要成果:
- 格拉姆阴性有机体占81.3%的分离物,其中大肠杆菌 (58.8%) 是最常见的,其次是Enterococcus spp. (17.5%) 和肺炎菌 (10.0%).
- 大肠杆菌对纳利迪西克酸 (84.4%),安皮西林 (78.1%) 和西普洛素 (78.1%) 呈现出高耐药性,但对斯福米辛 (90.6%),埃尔塔尼姆 (81.3%) 和尼托福兰因 (71.9%) 仍然敏感.
- 多种药物耐药性普遍存在,限制了治疗选择;Enterococcus spp. 显示出对四环素和勒沃素的高耐药性,但对线化物和万科迈素仍然敏感.
结论:
- 大肠杆菌 (Escherichia coli) 是儿童尿路感染的主要原因,对常见的抗生素有显著的耐药性.
- 斯福米,尼托福兰和卡巴因保持有效性,但明智使用至关重要,以防止加速耐药性.
- 针对儿童的AMR监测和抗菌药物管理计划对于保持治疗疗效和改善治疗结果至关重要.
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