标题：激素依赖型肾病综合征患儿泌尿系感染病原菌的分布及耐药性分析

      作者：赵 岫，王红梅，张 琴，刘 霞，王 立，陈 蔚，高晓洁
    (深圳市儿童医院内科，广东 深圳 518026)

      卷次： 2013年24卷20期

      【摘要】 目的 分析激素依赖型肾病综合征患儿泌尿系感染病原菌的分布及其耐药性，为临床合理治疗提
供依据。方法 对本院2007年1月至2012年12月激素依赖型肾病综合征患儿的96份尿液进行培养及鉴定，并
对其结果进行统计分析。结果 59份培养阳性标本中检出 72株病原菌，主要病原菌为革兰氏阴性菌，占
73.61%，其中前三位为：大肠埃希菌占23.61%，铜绿假单胞菌占18.06%，肺炎克雷伯菌占13.89%，这三种病原菌
对亚胺培南、呋喃妥因、哌拉西林/他唑巴坦有良好的敏感性，大肠埃希菌和铜绿假单胞菌对头孢他啶、头孢吡肟
耐药率较低。激素联合免疫抑制剂治疗的患儿尿培养阳性检出率73.33%明显高于单用激素的患儿。结论 大
肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌为激素依赖型肾病综合征患儿泌尿系感染常见病原菌，尤其铜绿假单
胞菌感染率明显升高。这三种细菌对呋喃妥因、哌拉西林/他唑巴坦、亚胺培南耐药率低。激素依赖型肾病综合
征患儿尤其是联合免疫抑制剂者在泌尿系感染过程中更应重视尿培养及药敏鉴定。

      【关键词】 激素依赖型肾病综合征；泌尿系感染；病原菌；耐药；抗菌药物；患儿

      【中图分类号】 R726.9 【文献标识码】 A 【文章编号】 1003—6350（2013）20—3032—04


Distribution and drug resistance of pathogens causing urinary tract infection in children with
steroid-dependent nephrotic syndrome.
ZHAO Xiu, WANG Hong-mei, ZHANG Qin, LIU Xia, WANG Li, CHEN Wei,
GAO Xiao-jie. Department of Cardiology, Shenzhen Children's Hospital, Shenzhen 518026, Guangdong, CHINA

【Abstract】 Objective To investigate the distribution and drug resistance of pathogens causing urinary tract
infection in children with steroid-dependent nephrotic syndrome. Methods A total of 96 urine specimens collected
from children with steroid-dependent nephrotic syndrome in our hospital from Jan. 2007 to Dec. 2012 were cultured
and detected for distribution and drug resistance. Results A total of 72 pathogens were isolated in the 59 specimens
with positive results, mainly Gram-negative bacterium (73.61%). The mostly common gram-negative bacterium found
were Escherichia coli (23.61%), Pseudomonas aeruginosa (18.06%), and Klebsiella pneumoniae (13.89%). These three
pathogens were sensitive to imipenem, nitrofurantoin and topiperacillin/tazobactam. Escherichia coli was and Pseu-
domonas aeruginosa were sensitive to Ceftazidime and cefepime. The patients with steroid-dependent nephrotic syn-
drome treated with glucocorticoids and immune inhibitors had high urine culture positive detection rate (73.33%)
than those treated with glucocorticoids. Conclusion Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneu-
moniae are the most common pathogens of urinary tract infection in steroid-dependent nephrotic syndrome, and the
infection rate of Pseudomonas aeruginosa increases significantly. The three pathogens were quite sensitive to imipen-
em, nitrofurantoin and topiperacillin/tazobactam. Pediatrician should pay attention to the pathogens detection and
drug resistance, and use antimicrobials correctly according to the results of drug sensitivity test in urinary tract infec-
tion in children with steroid-dependent nephrotic syndrome, especially those treated with glucocorticoids and im-
mune inhibitors.

      【Key words】 Steroid-dependent nephrotic syndrome; Urinary tract infection; Pathogens; Drug resistance; Anti-
microbial; Children
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