Distribution And Drug Sensitivity Of Pathogenic Bacteria In 447 Cases Of Urinary Sepsis In Urology Department

Objective: To investigate the etiology and drug resistance of urinary sepsis,providing evidence for clinical understanding of the etiology of urinary sepsis and rational selection of antibacterial drugs.Methods: Patients who were diagnosed with urinary sepsis in the urological department of the First Affiliated Hospital of Guangxi Medical University during 2013-2018 were collected.The patient’s urine specimen was cultured.The pathogens in the urine were separated and identified,the source and type were analyzed,and the drug sensitivity test was performed on the isolated pathogens.Analyzed and compared the pathogen distribution and drug resistance characteristics of positive patients.Result: During 2013-2018,447 patients with urinary sepsis were enrolled.920 urine samples were collected and 233 strains of pathogens were detected.The detection rate was 25.1%.Excluding duplicate strains of the same patient in a single hospitalization,there were still 201 positive results left.Among them,there were 137 strains(68.2%)of Gram-negative bacilli,and the top three were Escherichia coli,Pseudomonas aeruginosa,and Pseudomonas putida,with the proportions being 36.3%,7.5%,and 5.0%,respectively;There were 34 strains of Gram-positive cocci(16.9%),and the top three were Enterococcus faecium(7.5%),Enterococcus faecalis(7.0%),and Streptococcus agalactiae(1.4%);There were 30 strains(14.9%)of fungi,mainly Candida albicans(11.4%),followed by Candida glabrata(1.9%).The pathogens of urinary sepsis were still mainly Gramnegative bacilli,but they have a tendency to decrease year by year.Among the drug-sensitive test results,the most sensitive antibacterial drugs for Gramnegative bacilli are carbapenems of imipenem,meropenem and ertapenem;followed by aminoglycosides of amikacin,followed by piperacillin sodium/tazobactam sodium and cefoperazone sodium/sulbactam sodium in a β-lactam antibiotic/enzyme inhibitor compound preparation.The most resistant antibiotics were ampicillin,ciprofloxacin,cefazolin and piperacillin,of which ampicillin was the most resistant,reaching 91.5%.Among the Gram-positive cocci,the most sensitive antibacterial drugs are linezolid,teicoplanin,tigecycline and vancomycin,with a sensitivity of 100%.The highest rate of resistance is tetracycline,followed by minocycline,levofloxacin and ciprofloxacin.Most of the fungi lack the results of drug-sensitive experiments and cannot draw valid conclusions.The drug sensitivity of Escherichia coli and Pseudomonas aeruginosa to meropenem,imipenem,ertapenem,piperacillin sodium/tazobactam sodium,nitrofurantoin,cefoxitin,ciprofloxacin,piperacillin,and compound sulfamethoxazolethe were statistically significant(P< 0.05).Conclusion: The pathogenic bacteria in patients with urinary sepsis in urology are mainly Gram-negative bacilli,but they have a tendency to decrease year by year,gram-negative bacilli are most sensitive to carbapenems and aminoglycoside antibiotics.The drug-sensitivity of Gram-positive cocci showed a significant polarization trend,of whose sensitivity to linezolid,teicoplanin,tigecycline and vancomycin reached 100%.Urinary sepsis has the characteristics of rapid progress and high lethality.It should be vigilant and use high-efficiency antibacterial drugs in time.