Analysis Of The Diversity Of Causative Agent Species And Antibiotic Susceptibility In Maintenance Hemodialysis Patients Complicated With Infection

Objective: Investigating the diversity of causative agent species and antibiotic susceptibility in maintenance hemodialysis patients for providing epidemiological basis for the prevention and control of infection,guiding the proper selection of antibiotics,motivating the treatment effect and the prognosis.Methods: A sum of 771 MHD patients with positive culture of causative agent during hospitalization in the section of Nephrology of the First Affiliated Hospital of Chongqing Medical University from Jan.2016 to Dec.2020 were chosen as the experimental samples.Statistical verify the datum of cases information,diversity ratio of infected sites,distribution diversity of causative agent and drug sensitivity results of the target population by using SPSS 26.0 statistical software.Results:(1)Trait of infected sites and datum of cases information:Among the 771 MHD patients with positive culture of causative agent,male 370 cases,accounting for 48%;female 401 cases,accounting for 52%;the mean age of the population was 65.86±8.97 years.The top four dominating infected sites,number and proportion were:urinary system 270 cases,accounting for 35%;respiratory system 246 cases,accounting for 32%;CRBSI 123 cases,accounting for 16%;Digestive system 92 cases,accounting for 12%.(2)distribution diversity of causative agent:Among the 771 MHD samples,GNB 348 cases,accounting for45.1%;GPC 322 cases,accounting for 41.8%;fungi 91 cases,accounting for 11.8%;GNC 10 cases,accounting for 1.3%.Among GNB,E.coli 129 cases,accounting for 16.7%;Among GPC,S.aureus 122 cases,accounting for 15.8%;Among fungi,C.albicans 42 cases,accounting for5.4%.(3)Diversity of drug sensitivity:The antibiotic tolerance ratio of GNB were: ampicillin(85.8%),cefazolin(72.0%)and cefuroxime(63.1%);the antibiotic sensitivity ratio of GNB were: tigecycline(96.5%),ertapenem(94.4%),imipenem(94.2%),meropenem(94.2%)and amikacin(90.4%).The antibiotic tolerance ratio of GPC were: penicillin(77.7%),clindamycin(71.4%),erythromycin(70.3%)and ampicillin(61.6%);the antibiotic sensitivity ratio of GPC sensitivity rates were: datoromycin(100%),tegacycline(100%),teicolanin(100%),linezolid(98.0%)and vancomycin(97.8%).The fungi were completely sensitive to Amp B(100%),highly sensitive to 5-FU(97.8%),sensitive to echinalins(more than 80%),and sensitive to triazole(more than 70%).In addition,the antibiotic tolerance ratio of fungi to Amp B and 5-FU were lower than those of triazole and echinomycin(P < 0.05).Conclusions: In 771 MHD patients with positive culture of causative agent,the dominating infected persons were elderly people and woman;the dominating infected site was urinary system.There were various species of causative agent,and the proportion of GNB and GPC was relatively high,and the diversity of drug sensitivity of various species of causative agent had discrepancy.In clinical practice,antibiotics should be used reasonably according to various causative agent infections and drug sensitivity to boost the treatment effect.