Analysis Of The Distribution And Antimicrobial Resistance Vicissitudes Of Urinary Tract Infection Among 1458 Cases In Urinary Surgery Department Of Our Hospital

Objective:Investigate the distribution and antibiotic resistance vicissitudes trend of urinary tract infection in-patients in Urinary Surgery department in the First Affiliated Hospital of Guangxi Medical University is to inprove basis for clinical diagnosis and treatment of UTI and provide the rational use of antibacterial drug 2011-2014.Methods:Depict the distribution of the pathogenic bacteria seperated from the urine specimens from 1458 inpatients with UTI in Urinary Surgery department in the First Affiliated Hospital of Guangxi Medical University from January 1st 2011 to December 31st 2014.Research the antimicrobial resistance of common clinical gram-negative bacillus and gram-positive cocci to antibiotics over the past four years, and explore their drug resistant transition. To statistical analyze their trend of transition by SPSS 16.0 software. The X2 Test(when there was more than one fifth black 1<T<5 or one black T<1 use exact probability) is adopted and P<0.05 is indicated the difference statistically significant.Results:597 strains pathogens were isolated from 1458 urine specimens of UTI inpatients, including 1281 etiology specimens(urine cultures+drug sensitivity).The etiological examination is 87.9%,and the detection rate is 46.6%. According to the statistic result of the urine culture in our hospital over the past 4 years,472 gram-negative bacilli(79.1%) were isolated.The top three are Escherichia coli(46.9%),Enterobacter cloacae(7.2%),Pseudomonas aeruginosa(6.0%).71 gram-positive cocci(11.9%) were isolated,the top three are nterococcus faecalis(6.4%),enterococcus faecium(2.8%), streptococcus(1.5%).54 fungus(9.0%) were isolated,giving priority to candida albicans(5.9%),followed by candida glabrata and candida tropicalis.The total fungus is on the rise year by year,from 4.5% in 2011 to 16.3% in 2014.Carbapenem (ertapenem, meropenem, imipenem) is the highest sensitive to gram-negative bacillus, followed by amikacin of aminoglycosides, and third is beta lactam antibiotics/enzyme inhibitor compound preparation(piperacillin,tazobactam,cefoperazone and sulbactam). Escherichia is not found to drug resistant to meropenem. The drug of high resistance to gram-positive cocci are teicoplanin, tigecycline, vancomycin, and linezolid. The persister of teicoplanin and tegecycline has not been found. The highest drug resistance rate of antibiotics is erythrocin, followd by tetracycline, CPFX,and levofloxacin, the drug resistance of escherichia coli to cefoperazone and sulbactam is on rise year by year;the drug resistance of enterococcus faecalis to erythrocin is on rise year by year; The drug resistance of enterobacter cloacace and enterococcus faecium didn’t change evidently. KPN and escherichia are common bacterial strain of ESBLs-producing. Excepted carbapenem to escherichia, the antibiotic’s drug resistance of ESBLs producing is higher than that of non-ESBLs producing.Conclusion:The pathogenic bacteria isolated from UTI of Urinary Surgery Department in our hospital is based on gram-negative bacilli,which is reducing year by year; Gram-positive cocci and fungus is on rise year by year; Common clinical pathogenic bacteria is drug resistant to antibacterial to varying degrees. To fully recognize the drug resistance detection of bacteria is important to clinical diagnosis and treatment of UTI.