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【Objective】 To compare the clinical application value of controllable negative pressure suction outer sheath and ordinary flexible endoscope outer sheath in flexible ureteroscopic lithotripsy with holmium laser in the treatment of renal calculi less than or equal to 2 cm in diameter. 【Methods】 A total of 85 patients with renal calculi were selected and randomly divided into negative pressure group (n=45) and ordinary group (n=40). The operation time, complications, infection indexes 2 h after operation, adverse reactions, treatment efficacy and stone-clearance rate were compared between the two groups. 【Results】 The sheath was successfully implanted and holmium laser lithotripsy was performed in both groups. The negative pressure group had significantly shorter operation time than the ordinary group [(43.3±4.9) min vs. (66.2±5.8) min, P0.05). The increase of infection indexes (procalcitonin and leukocyte) 2 h after operation were significantly lower in the negative pressure group than in the ordinary group (P<0.05). The efficacy in the negative pressure group was 91.11% (41/45) and the stone-clearance rate was 95.56% (43/45), which were significantly better than those in the ordinary group (72.50% (29/40) and 80% (32/40), respectively. The total incidence of adverse reactions such as renal colic, gross hematuria and ureteral stone street was higher in the ordinary group than in the negative pressure group (P<0.05). 【Conclusions】 Controllable negative pressure suction sheath in flexible ureteroscopic lithotripsy is more effective, as the circulation perfusion keeps the operation field clear, reduces the operation time and improves the stone-clearance rate, while the negative pressure suction lowers the pelvis pressure to prevent infectious urine from entering the blood.
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Objective To explore diagnostic value of the serum and urine procalcitonin (PCT) detecting in the urinary system infection.Methods The serum and urine PCT levels in 45 urinary system infection patients with clear pathological diagnosis (exclude other system infections) who were outpatiented or hospitalized in the People's Hospital of Zhongshan between March and November 2016 (including 21 cases of upper urinary tract infection and 24 cases of lower urinary tract infection) and 35 healthy adults who went through physical examinations at the hospital during the same period,were measured using electrochemiluminescence immunoassay (ECLIA) on Cobase 601 Immunoassay Analyzer and analyzed to compare the differences of PCT levels in the three groups.Results The urine PCT level in upper urinary tract infection group was 0.243± 0.123 ng/ml.It was significantly lower than lower urinary tract infection group (0.486±0.232 ng/ml,t=4.11,P=0.000) and control group (0.454± 0.253 ng/ml,t=3.96,P=0.000).The serum PCT level in upper urinary tract infection group was 0.062±0.014 ng/ml.It was obviously higher than that in lower urinary tract infection group (0.043±0.020 ng/ml,t=3.56,P=0.01) and control group (0.032±0.013 ng/ml,t=7.38,P=0.000).In all groups,the urine PCT levels were significantly higher than their serum PCT levels (t =9.48,9.12,6.79,P＜ 0.01),and significant differences were observed in them.The sensitivity,specificity,positive predictive value and negative predictive value of serum PCT for diagnosing upper urinary tract infections were 81.5％,84.2％,80.6％ and 85.6％ respectively,and the urine PCT were 86.4％,80.7％,88.4 ％ and 83.1 ％ respectively.Conclusion Detection of serum and urine PCT has important accessory diagnostic value for identifying upper and lower urinary tract infections.
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Objective To analyze the difference in constituent and antimicrobial resistance of pathogens in commu-nity-associated urinary tract infection(CA-UTI)and healthcare-associated UTI(HA-UTI).Methods Clinical data and microbial detection of urine specimens of 960 patients with UTI in a hospital between January 2013 and June 2014 were investigated retrospectively,difference in constituent and antimicrobial resistance of pathogens were ana-lyzed.Results 403 cases were CA-UTI,and 557 were HA-UTI;pathogens in both CA-UTI and HA-UTI were gram-negative bacteria,accounting for 78.16% and 66.97% respectively.Constituent of pathogens in CA-UTI and HA-UTI were significantly different(χ2 =21 .68,P <0.001 ).Resistant rates of Escherichia coli to piperacillin /tazobactam,cefazolin,cefoperazone / sulbactam,aztreonam,meropenem,ertapenem,gentamicin,and compound sulfamethoxazole were all significantly different between CA-UTI and HA-UTI (all P <0.05);Except aztreonam, resistant rates of Escherichia coli in HA-UTI to the other antimicrobial agents were all higher than CA-UTI.Re-sistant rates of Enterococcus faecium in HA-UTI to penicillin,ampicillin,gentamicin,levofloxacin,ciprofloxacin, and moxifloxacin were all higher than CA-UTI(all P <0.05).Conclusion Constituent and antimicrobial resistance of pathogens in CA-UTI and HA-UTI are different,proper antimicrobial agents should be chosen according to con-stituent features of pathogens and change in antimicrobial resistance,so as to prevent and reduce the emergence of drug-resistant strains,and improve therapeutic effectiveness.
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Objective To analyze the pathogen distribution and drug resistance in the patients with urinary system infection in our hospital so as to provide the basis for prevention and treatment of urinary system infection .Methods 259 strains of pathogenic bacteria cultured and isolated from the midstream urine were performed the bacteriologic identification and the drug susceptibility testing ,Escherichia coli and Klebsiella pneumoniae were performed the extend‐spectrum β‐lactamase (ESBLs) producing testing . Results Among 259 strains of bacteria ,187 strains 72 .2% (187/259) were Gram negative stains ,43 strains 16 .6% (43/259) were Gram positive stains and 29 strains 11 .20% (29/259) were fungi .Gram negative stains were dominated by Escherichia coli (139 strains) and Klebsiella pneumoniae (22 strains) .The detection rates of ESBLs‐producing Escherichia Coli and Klebsiella pneumoni‐ae were 55 .4% (77/139) and 45 .4% (10/22) .The drug susceptibility testing results showed that Gram negative stains were sus‐ceptible to both imipenem and meropenem (100% ) and Gram positive stains were susceptible to vancomycin ,teicoplanin and linezol‐id (100% ) .Conclusion Gram negative bacilli are the main infectious pathogens in urinary tract infection and Escherichia coli is the most common pathogen .No vancomycin‐resistant Gram positive cocci is found .Rationally selecting antibacterial drugs according to the drug susceptibility testing results has great significance in the therapy of urinary tract infection and the control of drug‐resistant bacterial strains .
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OBJECTIVE To study the risk factors of hospital acquired urinary system infection in neurology ICU(NICU) and emergency ICU(EICU).METHODS The general character,score of APACHE Ⅱ and the time length of urethral catheterization of the 502 NICU and EICU patients were enrolled in our study.Then the relativity of the risk factors and hospital acquired urinary system infection were investigated.RESULTS Urethral catheterization increased the chances of hospital acquired urinary system infection and there were more chances with the long time.CONCLUSIONS In order to decrease the rate of hospital acquired urinary system infection we must strictly grasp the indication of urethral catheterization and pull out the urethral catheter as early as possible.
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OBJECTIVE To understand pathogen distribution and drug sensitive rate of urinary system infection in our hospital,in order to avoid the clinic to use antibiotics blindly,make the resistant strains decreasing in number,and improve efficacy.METHODS The distribution and drug sensitivity of the pathogens causing urinary infection among the patients with urinary system infection were rectrospectively analyzed.RESULTS Totally 549 strains were isolated,G-bacteria were 333 strains,accounted for 60.66%,from them E.coli was 293 strains,accounted for 87.99%;and G+bacteria were 216 strains,accounted for 39.34%,from them Enterococcus,and Staphylococcus were the main ones.Of E.coli strains,the ESBLs(+) were 36.86%.The MRCNS accounted for 81.91%.The result of drug sensitivity showed that the sensitive rate of E.coli to meropenem and imipenem was 100.0%.The sensitive rate of ESBLs(+) E.coli to cefepime,cefotaxime and aztreonam was all lower than 50%,but that of ESBLs(-) to the above drugs was much higher than ESBLs(+).The sensitive rate of Enterococcus to vancomycin and teicoplanin was 100%.The sensitive rate of CNS to Vancomycin was 100%.CONCLUSIONS In order to decrease the produceing bacteria resistance and the disseminating the resistance genes,it′s necessary to enhance the monitoring and study of bacteria resistance,normlalize the clinical medicine application,and enhance the infection control measures.
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OBJECTIVE To investigate the variety of main pathogenic bacteria and their resistance in urinary system infection of type 2 diabetes mellitus(T2DM)in endocrinology department of our hospital and find out the best choice antibacterials of application.METHODS By retrospective analysis of clinical history,the results of urine bacterial culture,drug sensitivity reports of T2DM patients with urinary system infection were analyzed.The data were dealed with SPSS 11.0.RESULTS The drugs of experiential therapy were mainly quinolones.And drug resistant rates of Escherichia coli and Staphylococcus epidermidis to levofloxacin and ciprofloxacin were 18.2% and 63.6%,and 16.7% and 50.0% respectively.The treatment periods of 2 groups were(8.4?4.3)d and(10.4?5.4)d,respectively.CONCLUSIONS ?-Lactam/?-lactamase inhibitor and aminoglycosides are the first choice in experiential therapy.Thetreatment periods could be decreased according to bacterial culturingresults.
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@#Objective To assess the incidence of urinary tract infection after urodynamic studies for spinal cord injury patients. Methods 86 patients with spinal cord injury were underwent urodynamic studies,all paients were undertaken uronoscopy and urine culture before and after urodynamic studies. Group A applied no special treatment after urodynamic studies, group B applied preventive antibiotic treatment. Results The incidence rate of urinary tract infection after urodynamic studies in group A was 8.81%, 7.32 % in group B. There was no significant difference between two groups. Conclusion Urodynamic studies are safe, well-tolerated procedures, need not use prophylactic antibiotic after urodynamic studies.
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0.05).However,the total cost in the control group(502.40 yuan) was significantly higher than in the sequential group(266.96 yuan)(P
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OBJECTIVE To study the three-stage reports method using in clinical diagnosis of urinary system infections,and its value in order to fasten the clinical diagnosis and treatment.METHODS A total of 3349 urines specimens used a sequential three-stage reports method to prospectively evaluate and determine the validity of direct antimicrobial agent susceptibility testing by traditional method and VITEK-32.The first report was by Gram stained,the second report by criteria for initiating direct susceptibility testing,and third report was by standardized disk diffusion method and VITEK-32.RESULTS From 3349 samples the Gram negativstained smears were 746(22.3%),Gram negative bacilli were 1365(40.7%) the Gram positive cocci were 1036(31.0%) and the fungi were 202(6.0%).Escherichia coli rated the top one(55.7%),followed with Staphylococcus saprophyticus subsp saprophyticus 437(42.2%),Enterococcus faecalis 389(37.5%),Proteus,Klebsiella pneumoniae,Pseudomones aeroginose,and fungi.Enterobacteriaceae were showed increasing drug resistance trend,but still sensitive to imipenem(100.0%).G+-cocci were also showed serious drug resistance trend,but still sensitive to vancomycin(100.0%)(except E.faesium).CONCLUSIONS Three-stage method using in clinical diepnosis of urinary system infections is very important.Enterobacteriaceae are the main infectious bacteria in urinary system infection.Rational use of antibiotics should be carried out according to urine culture result.
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OBJECTIVE To determine the bacterial distribution and resistance status in urinary system infections among old patients with primary susceptibility testing on urine samples. METHODS A total of 990 urine specimens were examined over 3 years to determine the validity of direct antimicrobial agent susceptibility testing.A total of 1149 strains collected from inpatient urine specimens during Oct 2002-Oct 2005 were identified and the drug resistance test was performed. RESULTS Escherichia coli rated the top one(57.9%),followed with Enterococcus,Proteus,Klebsiella pneumoniae,Pseudomonas aeruginosa,Staphylococcus and fungi.Enterobacteriaceae were showed increasing drug resistance trend,but still sensitive to imipenem(100%).G~+-cocci were also showed serious drug resistance trend,but still sensitive to vancomycin(100%)(except Enterococcus faecium). CONCLUSIONS Enterobacteriaceae are the main infectious bacteria in urinary system infection.Rational use of antibiotics should be carried out according to urine culture result.
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OBJECTIVE To investigate distribution and drug resistance status of infections in urinary system and offer scientific basis for reasonable usage of antibiotics. METHODS Totally 258 isolates collected from urinary infection specimens were identified and drug susceptibility test was performed. RESULTS Escherichia coli rated the top one,73.3%.The isolates were susceptible to imipenem and amikacin.The resistant rate to other 6 antibiotics were above 50%. CONCLUSIONS The drug resistance rate of isolates collected from urinary infection specimens goes upward,so we should pay attention to.
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OBJECTIVE To understand pathogen distribution and drug resistance of urinary system infection in Langfang,then help the clinic to use drug rationally.METHODS Totally 846 bacteria were isolated from the urine and given in vitro drug sensiticity test with Kirby-Bauer method to detect special resistant strains such as MRS,VRE,HLAR and the ESBLs-producing bacteria.RESULTS The first 5 were Escherichia coli(60.2%),cogulase negative Staphylococcus (CNS,16.7%),Klebsiella pneumoniae(3.2%),Enterococcus(2.6%),and Proteus(2.1%).ESBLs-producing bacteria were 23.5%,MRS were 83.7%,HLAR were 59.1%,VRE were not detected.E.coli was sensitive to cefepime,piperacillin/tazobactam,ceftazidime,amikacin(71.0-99.0%).CNS was sensitive to vancomycin,piperacillin/tazobactam,nitrofurantoin,and ofloxacin(70.0-100.0%).Vancomycin-resistant CNS was not detected.CONCLUSIONS E.coli is the most encountered pathogen causing urinary system infection in Langfang,Then are CNS.Antibiotics we were used such as gentamicin,ciprofloxacin,et,al already produced higher resistance,so clinic should consider the drug sensitivity agent and special resistant strain and choice antibiotics rationally,to make the resistant streains decreasing in number.
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OBJECTIVE To investigate the distribution and drug resistance of pathogens in urinary system infection.METHODS Collected from patients urine specimens of our hospital during Jan 2004 Dec 2008 were cultured,detected and studied drug resistance.RESULTS Among these pathogens,Escherichia coli rated the top one(44%),followed by coagulase negative Staphylococcus,fungi,Enterococcus,Klebsiella pneumoniae,Proteus and Pseudomonas aeruginosa.The Enterobacteriaceae were sensitive to imipenem(100%) and the Enterococcues and Staphytlococcus were sensitive to vancomycin(100%).But they all showed higher drug resistance to other antibiotics.CONCLUSIONS E.coli from urinary tract infection is the most common pathogen.In the treatment of urinary tract infection the commonly used drugs such as gentamicin,ciprofloxacin,etc,have produced a higher resistance.Clinician should pay attention to the changes in their drug resistance and use correctly.
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0.05),however,the average cost in combined group was significantly lower than in single group(P
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Objective:To study bacterial distribution and antimicrobial resistance of 489 strains of bacteria isolated from clinical urinary specimens of inpatients in department of kidney diseases of our hospital from 2001 to 2002,and propose rational use of antibiotics.Methods:Bacteria was isolated and identified by routine methods.Antimicrobial susceptibility was tested by K-B method.Results:in the 489 strains,there were307 strains of gram-regtive bacilli which account for 62.5%,mean while,there were 182 strains of gran-positive cocci which acconnt for 37.5%.The gram-negative bacilli mainly included K.pneumonice P.mirabilis and E.aerogenes.And the gram-positive cocci mainly included enterococcus and serum coagulase negative staphylococcus.The gram-negative bacilli were sensitive to imipenem and piperacillin/tazobactam,while the gram-positive cocci were sensitive to vancomycin and Teicoplamin.Conclusion:The urinary system infection is always induced by E.coli and Enterococcus.The periodical detection for bacterial resistance has an important significance for clinical treatment.