Analysis Of Distribution And Drug Resistance Of Pathogenic Bacteria In Patients With Bacterial Pneumonia Complicated With Urinary Tract Infection

Objective To observe and analyze the general clinical characteristics,pathogen distribution and drug resistance of patients with bacterial pneumonia complicated with urinary tract infection,and to provide certain theoretical basis for the application of anti-infective drugs in clinical work.Methods Clinical data of inpatients diagnosed with bacterial pneumonia complicated with urinary tract infection in our hospital from September 2018 to May 2020 were collected,including:general information,sputum culture and urine culture and drug susceptibility test results and statistical analysis of bacterial pneumonia complicated urinary tract infection in patients with general information,pathogenic bacteria and drug resistance characteristic,for the selection of anti-infective drugs in clinical provide certain reference.Results 1.A total of 91 patients were included,including 35 males(38.5%)and 56 females(61.5%).The patients ranged in age from 29 to 91years old,with a mean age of 68.05±14.44 years old and a mean length of hospital stay of 12.74±5.907 days.The positive rate of sputum culture was44.6%,and the positive rate of urine culture was 58.5%.2.A total of 18patients(19.78%)had smoking history;38.46%(35/91)of the patients had hypertension,30.77%(28/91)of the patients had diabetes,20.88%(19/91)of the patients had Renal insufficiency,18.68%(17/91)of the patients had Coronary heart disease,18.68%(17/91)of the patients had Cardiac dysfunction,16.49%(15/91)of the patients had hypoproteinemia,10.99%(15/91)of the patients had COPD,10.99%(15/91)of the patients had respiratory failure,7.69%(7/91)of the patients had Liver dysfunction,3.30%(3/91)of the patients had Pulmonary embolism,2.20%(2/91)of the patients had asthma,13.19%(12/91)of the patients had Other complications.Among the symptoms,cough accounted for 60.44%,sputum accounted for 48.35%and fever accounted for 47.25%,while the percentages of frequent urination,urgent urination,dysuria and lumbago were 21.98%,17.58%,12.09%and 10.99%respectively.Dry and wet rales accounted for 49.45%.3.The WBC(≥10×109/L)accounted for 45.45%,neutrophils ratio(NEU-R≥75%)accoun-ted for 77.27%,procalcitonin(>0.05ug/L)accounted for 87.88%,CR-P(>10.0mg/d L)accounted for 81.82%,ALT(>50U/L)accounted for 18.18%,AST(>40U/L)accounted for 22.73%,creatinine(>97μmol)accounted for 31.82%,GFR(≥75m L/min)accounted for 45.45%.4.Sputum culture pathogenic bacteria were isolated from 70 strains,followed by pseudomonas aeruginosa(32.9%),klebsiella pneumoniae(22.9%),staphylococcus aureus(14.3%),acinetobacter baumannii(7.1%),onion burkholderia bacteria(7.1%),a broken leg,Baxter’s bacteria(5.7%),haemophilus influenzae(4.3%),the wizard acinetobacter,pew acinetobacter,eosinophilic malt narrow food and bacterium e.coli(1.4%)of each item,which is as high as 85.7%for G~-bacteria.The drug susceptibility results of the main pathogenic bacteria in sputum culture showed that the drug resistance rates of Pseudomonas aeruginosa to imipenem,meropenem,levofloxacin,ciprofloxacin were 60.9%,52.2%,52.2%,47.8%,respectively,and the drug resistance rates to cefotaxime,ceftriaxone,ceftazidime,suprusen,piperacillin were 0.0%,0.0%,4.3%,0.0%,respectively.The drug resist-ance rate of Klebsiella pneumoniae to cefuroxime was 56.3%,the positive rate of ESBLs was 31.3%,and the drug resistance rate to levofloxacin and meropenem were 0.0%.The drug resistance rates o-f Acinetobacter baumannii to ampicillin/sulbactam,cefepime,ceftazidime,ciprofloxacin,imipenem,meropenem and ticacycline were all 100.0%,and the drug resistance rates to levofloxacin,suprusen,gen-tamicin and cotrimoxazole were 80.0%,80.0%,60.0%,respectively.Staphylococcus aureus to ampicillin,penicillin,tetracycline,gentam-ycin,clindamycin resistant rate of 100.0%,90.0%,70.0%,60.0%,60.0%,of ceftriaxone,cefuroxime,levofloxacin,moxifloxacin,rina thiazole amine,vancomycin resistant rate to 0.0%.5.A total of 100 strains of pathogenic bacteria were isolated by urine culture,including 32 strains of Escherichia coli,5 strains of acidogenic Klebsiella,4 strains of Proteus singular,3 strains of Klebsiella pneumoniae,1 strain of Staphylococcus brevis,14 strains of Enterococcus faecium,3 strains of Enterococcus durans and Enterococcus quail,2 strains of Enterococcus aureus,and 32strains of fungi,among which G-bacteria accounted for 45.0%and G~+bacteria accounted for 23.0%.Drug sensitivity results of main pathogenic bacteria in urine culture:drug resistance rates of Escherichia coli to ampicillin,cotrimoxazole,ciprofloxacin,levofloxacin and cefazolin were81.3%,71.9%,68.8%,62.5%,respectively,and the positive rate of ESBLs was 56.3%.Produce acid klebsiella bacteria with cefepime,cefazolin,gentamycin,compound new Ming resistance were 60.0%,ESBLs po-sitive rate is 60.0%;The drug resistance rate of Klebsiella pneumo-niae to ampicillin/sulbactam,amtronam,cefepime,gentamicin,supru-sen,piperacillin,tetracycline and other antimicrobial agents was mo-re than60%,and the positive rate of ESBLs was 66.7%,but the drug resistance rate of all three strains to ertapenem and meropene-m was 0.0%.Enterococcus was the main bacteria in G~+(22/23,95.7%),of which Enterococcus faecium accounted for 63.6%(14/22).The drug resistance rates of the bacteria to ampicillin,ciprofloxacin,levofloxacin,penicillin and erythromycin were all 100.0%,and the drug resistance rates to furantamide,rifampicin and genamicin were 50.0%,85.7%and 57.1%,respectively.Other enterococcus to ampicillin,ciprofloxacin,levofloxacin,penicillin resistance were 100.0%,of gentamicin,erythromycin,rifampicin,tetracycline resistance were 75.0%,75.0%,75.0%and 62.5%respectively;The resistance of staphylococcus aureus to penicillin,clindamycin and erythromycin was 100.0%.All enterococcus and s.aureus isolates on chloramphenicol,doxycycline,rina thiazole amine,vancomycin resistant rate are 0.0%.Conclusion 1.Bacterial pneumonia complicated with urinary tract infection was more common in elderly patients,among which females accounted for a higher proportion and generally had a longer hospital stay;And the patient’s symptoms are mainly cough,expectoration,fever,a few can appear frequent urination,urgent urination,urination pain and lumbago.2.The results of sputum culture and urine culture of patients with bacterial pneumonia complicated with urinary tract infection were mainly gram negative bacteria,and pseudomonas aeruginosa,klebsiella pneumoniae,acinetobacter baumannii and escherichia coli were the most common bacteria.And gram-positive bacteria is given priority to with enterococcus and staphylococcus aureus.3.The gram-negative bacteria resistance in bacterial pneumonia complicated with urinary tract infection is common,and the proportion of producing ESBL is relatively high,among which klebsiella pneumoniae,escherichia coli and acinetobacter baumannii are the most common bacteria,among which acinetobacter baumannii presents multiple drug resistance and high drug resistance rate.