| ABSTRACT Objective:To explore the distribution and drug resistance of pathogens causing acute pyelonephritis in children patients and accumulate experience for clinical treatment of the disease so as to improve the cure rate. Methods:A total of 134 children patients with acute pyelonephritis, who were treated in our hospital from January 2015 to October 2017.The characteristics and drug resistance of the pathogenic bacteria were retrospectively analyzed. Record of the use of antibiotic and the results of their treatment during the period of the hospital. Results: Totally 64 strains of pathogens have been isolated form the 152 specimens of 134 children patients (susceptibility testing done 51), among which 21 (32.81%) strains of Escherichia coli were dominant, of which 12 were ESBLs producing strains, 9 were non ESBLs producing strains. Followed by 14 strains of Enterococcus faecium (21.88%); 11 strains of Enterococcus faecalis (17.19%); 4 strains of Klebsiella pneumonia (6.25%), of which 3 strains were ESBLs producing strains; ESBLs producing strains resistant to cephalosporin, cefoperazone sodium and sulbactam, piperacillin and tazobactam resistance rate was relatively low. Enterococcus resistance to erythromycin was up to 100%, vancomycin, fosfomycin, linezolid, teicoplanin resistance rates were very low. Ampicillin resistance rate was 70%, ESBLs producing strains and Enterococcus faecium was 100% resistant to it. The resistance of carbapenems was temporarily at a low level. The third generation of cephalosporin (cefixime and cefatriaxone) was the main antibiotics used in our hospital. Cefoperazone and sulbactam, ampicillin and tazobactam were the most frequently used antibiotics. Of the 134 patients who were discharged, 11 cases were cured and 123 were improved. Conclusion:Escherichia coli, Enterococcus faecium and Enterococcus faecalis are the three main pathogens of acute pyelonephritis in children. The composition ratio of Enterococcus in the pathogens of urinary tract infection is increasing. Combined with clinical practice for children with acute pyelonephritis patients, third generation cephalosporin is preferred. For the treatment of ESBLs producing strains in the case of third generation cephalosporins ineffective given carbapenems and sulbactam or tazobactam compound preparation is more appropriate. |
