Analysis on the main pathogenic bacteria and risk factors of 891 cases in hospital with urinary tract infections / 中国综合临床

ABSTRACT

Objective To investigate the distribution and drug resistance of major pathogens for urinary tract infections and related risk factors of hospitalized patients for prevention and treatment of urinary tract infections and to guide the reasonable application of antibiotics.Methods From January 2007 to December 2013 ,the risk factors and pathogen resistance of hospitalized patients with urinary system infection in the First People' s Hospital of Shangqiu were analyzed.Results Totally 891 strains were isolated, in which 638 (71.6％) were Gram-negative strains, 218 (24.5％) were Gram-positive strains, and 35 (3.9％) were Candida.Among Gram-negative strains, Escherichia coli was the most prevalent species, accounting for 43.5％, followed by Enterococcus spp(22.1％), major strains were Enterococcus faecalis and Enterococcus faecium.About 62.1％ (553/891) of the strains were isolated from female patients, 37.9％ (338/891) from male patients.The prevalence of ESBLs-producing strains in Escherichia coli, Klebsiella spp and P.Mirabilis were 59.0％ (526/891), 57.8％ (515/891) and 15.1％ (135/891).ESBLs-producing Enterobacteriaceae strains were more resistant than non-ESBLs-producing strains in terms of antibiotic resistance rate.The ESBLs-producing Enterobacteriaceae strains were highly susceptible to carbapenems.The average prevalence of Pseudomonas aeruginosa was 4.0％(36/891).Six strains were identified as multi-drug resistance of Pseudomonas aeruginosa were respectively, and 3 were carbapenem-resistant strains.Enterococcus spp were completely sensitive to linezolid, vancomycin and teicoplanin.Among Candida strains,the major strains Candida albicans was completely sensitive to amphotericin B, amphotericin and nystatin.The percentage of Candida albicans resistant to itraconazole,voriconazole and fluconazole was 13.0％ (116/891), 17.4％ (155/891) and 39.1％ (348/891).Clinical urinary tract infections related to sex, age, basic diseases, invasive operation and unreasonable application of antibiotics significantly (P＜0.05).Conclusion Escherichia coli is the leading clinical isolates strains account for most urinary tract infections in the First People' s Hospital of Shangqiu, followed by Enterococcus spp.The prevalence of Candida albicans is the major strains among Candida strains.Should be pay attention to the susceptible population and apply anbiotics reasonably.