Etiological Profiles and Antibiotic Resistance of Urinary Tract Infections Among Different Age Categories in Children: A Retrospective Study of Xiamen Single-Center.

IF 2.9 3区 医学 Q2 INFECTIOUS DISEASES
Infection and Drug Resistance Pub Date : 2025-09-03 eCollection Date: 2025-01-01 DOI:10.2147/IDR.S537033
Zhuqin Zhan, Jianying Liao, Xiaoliang Lin, Guangbo Li, Dequan Su, Jinhua Zeng, Qian Shen
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Abstract

Purpose: To analyze the distribution of pathogens and drug resistance in children with urinary tract infections (UTIs) in a single center in Xiamen and to guide the selection of empirical antibiotics in the clinic.

Methods: Clinical data of 2001 children with UTIs in Xiamen Children's Hospital between 2014 and 2022 were retrospectively analyzed, grouped by age and comorbidities. Differences in pathogen distribution and drug sensitivity were compared with the chi-square test applied and significance set at p < 0.05.

Results: Of 2001 urine samples collected, 965 (42.73%) had positive results for common infections. Gram-negative bacteria predominated (644/965; 66.74%), with Escherichia coli being the most prevalent (432/965; 44.77%). The top five pathogens were Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, Enterococcus faecalis, Pseudomonas aeruginosa. The percentage of Escherichia coli was higher in simple UTIs than complex (54.01% vs 45.35%), and Pseudomonas aeruginosa (9.59% vs 2.74%) and fungi (7.27% vs 1.96%) were higher in complex UTIs (p < 0.05). Predominance of Pseudomonas aeruginosa and Enterococcus faecalis in boys and Enterococcus faecalis in girls. Escherichia coli had a significantly lower rate of resistance to ampicillin than Klebsiella pneumoniae (p < 0.001), and both had a high rate of resistance to cephalosporins (over 95% to cefazolin), but a low rate of resistance to amikacin and furotoxin. Pseudomonas aeruginosa had 100% resistance to most cephalosporins, but less than 7% to ceftazidime, cefepime and piperacillin tazobactam. Enterococcus faecalis had over 90% resistance to Ampicillin, Penicillin, Linezolid and 91.53% to tetracycline. No Tigecycline/Vancomycin-resistant enterococci were found. Both Gram-negative and Gram-positive bacteria maintained relatively low rates of resistance to Nitrofurantoin.

Conclusion: Pediatric UTIs in Xiamen show gender-based pathogen differences, mainly gram-negative. Nitrofurantoin is preferred for mild cases, and the clinical selection should be individualized by combining the regional pathogen spectrum and drug sensitivity.

Abstract Image

厦门市不同年龄段儿童尿路感染的病原学特征及抗生素耐药性回顾性研究
目的:分析厦门市单一中心尿路感染(uti)患儿病原菌分布及耐药情况,指导临床经验性抗菌药物的选择。方法:回顾性分析厦门市儿童医院2014 ~ 2022年2001例尿路感染患儿的临床资料,按年龄及合并症进行分组。病原菌分布和药敏差异采用卡方检验,p < 0.05为显著性。结果:2001例尿样中,常见感染阳性965例(42.73%)。革兰氏阴性菌居多(644/965;66.74%),大肠杆菌最多(432/965;44.77%)。病原菌前5位分别为大肠杆菌、粪肠球菌、肺炎克雷伯菌、粪肠球菌、铜绿假单胞菌。单纯UTIs中大肠杆菌的检出率高于复杂UTIs(54.01%比45.35%),复杂UTIs中铜绿假单胞菌(9.59%比2.74%)和真菌(7.27%比1.96%)检出率高于复杂UTIs (p < 0.05)。男孩以铜绿假单胞菌和粪肠球菌为主,女孩以粪肠球菌为主。大肠杆菌对氨苄西林的耐药率明显低于肺炎克雷伯菌(p < 0.001),对头孢菌素的耐药率均较高(对头孢唑林的耐药率超过95%),但对阿米卡星和呋喃毒素的耐药率较低。铜绿假单胞菌对大多数头孢菌素的耐药率为100%,对头孢他啶、头孢吡肟和哌拉西林他唑巴坦的耐药率低于7%。粪肠球菌对氨苄西林、青霉素、利奈唑胺的耐药率超过90%,对四环素的耐药率为91.53%。未发现耐替加环素/万古霉素肠球菌。革兰氏阴性菌和革兰氏阳性菌对呋喃妥因的耐药率都相对较低。结论:厦门市儿童尿路感染病原菌存在性别差异,以革兰氏阴性为主。硝基呋喃妥因适用于轻症患者,临床应结合地区病原菌谱和药物敏感性进行个体化选择。
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来源期刊
Infection and Drug Resistance
Infection and Drug Resistance Medicine-Pharmacology (medical)
CiteScore
5.60
自引率
7.70%
发文量
826
审稿时长
16 weeks
期刊介绍: About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.
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