Distribution And Resistance Trends Of Pathogens From Urinary Tract Infections

Objective To investigate the bacterial profile and pattern of antibiotic resistance of urinary tract infections pathogen. Methods It was analyzed that the distribution and resistance of pathogens in 154 culture-positive community-acquired urinary tract patients from January to December in 2004 . Results Gram-negative bacilli accounted for 44. 8%, with 36.4% of Escherichia coli. Gram-positive cocci accounted for 41.6% .with 17.5% of Staphylococcus ,13.0% of Enterococci ,11.0% of Streptococcus. Followed Corynebacterium with 5.8% and fungi accounted for 4.5%. Escherichia coli had the highest resistance rate of 70.4% for ampicillin, followed Sulphamethoxazole/trimethoprim(SMZ/TMP) with 55. 6% and Ciprofloxacin(CIP) with 50%. Resistance rate of Escherichia coli for ampicillin/sulbactam (20%) was significantly lower than that to ampicillin alone (P<0.01). Resistance rate of Escherichia coli to amikacin (AMK)was significantly lower than that to gentamycin(11. 9% vs 44. 2%, P<0.01). Nitrofurantoin(NIT) also had as low resistance rate(11. 4%) . as amikacin. Great proportion of Gram-positive cocci was resistant to CIP ranging from 63.3% to 77.3%. The resistance rate to Erythromycin was above 70%. The same result was found in SMZ/TMP, above 50%. Staphylococcus had the highest resistance rate of 90.9% for penicillin G.There was a Staphylococcus aureus isolate that was med-sensitive toGlucopeptides(GISA) in our result. A proportion of 28. 6% Enterococci were resistant to VAN, but sensitive to Teicoplanin. The sensitivity of nitrofurantoin in cocci was just a little bit less than VAN. All the Corynebacteriums were resistant to CIP, but none to VAN. Conclusions Bacteria spectrum in urinary tract infections changed a lot. Though E. coli is still the major pathogen , there is a tendency toward increased proportion of cocci , Corynebacteriums and fungi, especially the Staphylococcus. The amount of VRE is increasing and VRSA is found. Resistance rates among commom uropathogens continue to envolve and appear to be increasing to commonly used agents especially to quinolones and sulfanilamides. Continued surveillance of resistance rates among uropathogens is needed to ensure appropriate recommendations for the treatment of the infections. According to the results, a good suggestion for the empirical management of UTIs seems to be NIT and AMK.