ABSTRACT
Objective To estimate the value of nitrofuratoin in uncomplicated urinary tract infection by examining antimicrobial resistance of Escherichia coli (E.coli) strains isolated from the patients.Methods The antimicrobial susceptibility information was collected from two projects: an antimicrobial survey of clinical urine specimens in 20 hospitals in 15 provinces during 2004-2012 and CHINET Antimicrobial Resistance Surveillance Program during 2005-2014.Then the clinical consumption of nitrofuratoin was analyzed according to the data of sample hospitals from 6 cities of Yangtze River system between 2011 and 2015.Results The antimicrobial susceptibility of E.coli strains showed that the resistance rate to cephalosporins and fluoroquinolones were above 50% during the last decade.Meanwhile,the resistance rate to nitrofuratoin was below 10%.Conclusion Nitrofuratoin,which is an old drug in the treatment of urinary tract infection,is famous for its broad-spectrum antimicrobial activity and high sensitivity to ESBLs producing or non-ESBLs producing strains of E.coli.It is efficacious,safe and cost-effective in the treatment to uncomplicated urinary tract infection in women.Therefore,it is highly recommend that rational use of nitrofuratoin in the clinical practice.
ABSTRACT
Diabetes complicated with urinary tract infection is influenced by many factors, such as low immune function, high blood and urine glucose environment prone for bacterial growth, and nervous lesion.Diabetic urinary tract infections are characterized by insidious onset, high recurrence rate, correlation with high blood glucose and difficulty to control.The related bacterial pathogens are mainly gram-negative bacillus genus ( 58. 59%-76. 19%) , in which the detection rates of extended spectrum β lactamases( ESBLs) Escherichia coli and Klebsiella pneumonia were the highest, followed by Enterobacter cloacae. Gram-positive bacteria only accounted for 23%. Drug-resistant bacteria and fungi would increase under the condition of repeated infection and irrational usage of antibiotics.In recent years, the urine-derived sepsis caused by urinary tract infection had become a popular clinical research topic because of its concealed symptoms, acute onset, rapid development and high mortality. By reviewing domestic and foreign literatures and expert consensus, this article is intended to explore the characteristics and treatment of diabetic urinary tract infections to supply reference for early prevention, correct diagnosis and effective treatments.