Distribution And Resistance Analysis Of Pathogens From Urinary Tract Infection Of Xining City In 2009～2010

Objective:To investigate the distribution and drug resistance of pathogenic bacteria in urinary system infection of xining city from 2009 to 2010,and to provide reliable evidence for diagnosis and treatment of urinary system infection disease and guide the rationa1 administration of antibiotics.Methods: A total of 1013 pathogen strains in urinary system infection inpatients from Qinghai province people's hospital in 2009～2010 were cultured and identified by ATB Expression and drug sensitivity test was performed. ESBLs-producing strains isolated from E.coli and K.pneumoniae were identified by phenotypic comfirmatory test.Results:In 2009, Gram-negative bacilli accounted for 77.18%, Gram-positive cocci accounted for 20.31% and Fungi accounted for 2.51%. In 2010, Gram-negative bacilli accounted for 77.62%, Gram-positive cocci accounted for 18.35% and Fungi accounted for 4.03%.There was no difference in the constituent ratio of the three strains between the two years(P>0.05). The proportion of each bacterial flora of Gram-negative bacilli was significent(P<0.05) . Among them, the proportion of E. coli , Proteus, other E. coli bacterials and Acinetobacter baumannii declined, the proportion of Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa and other fermentation coli increased. There was no difference in the proportion of each bacterial flora of both Gram-positive cocci and Fungi(P>0.05), Enterococci accounts the highest proportion of Gram-positive cocci and Candida albicans accounts the highest proportion of Fungi .The detection rate of ESBLs-producing E. coli was 58.71% and the detection rate of ESBLs-producing K.pneumoniae was 51.11%. The resistance rate for meropenem and imipenem was very low in ESBLs-producing strains and non-ESBLs-producing strains of E. coli. The resistance rate for amikacin was not significant in statistics in ESBLs-producing strains and non-ESBLs-producing strains of E. coli(P>0.05). The resistance rate for penicillin, cephalosporins, and etc. of the antibiotics was significant in statiatics in ESBLs-producing strains and non-ESBLs-producing strains of E.coli(P<0.05).Enterococci had the higher resistance rate of more than 75% for penicillin and quinolones. It was not significant in statistics in similar antibiotics(P>0.05). Enterococci was sensitive to vancomycin and teicoplantin.The resistance rate for quinolones and penicillin in staphyloccus was above 80% and 55%. It was not significant in statistics in similar antibiotics(P>0.05). Staphyloccus was sensitive to fusidic, vancomycin, tetracycline, quinupristi/dalfopristin and nitrofurantoin.Fungi was sensitive to amphotericin B, itraconazole and vorionazole. Fungi had the resistance rate of 48.08% for flucytosine and the resistance rate of 9.09% for fluconazol(P<0.05).Conclusions:E.coli is still the major pathogen in urinary tract infection, followed enterococci and staphyloccus. Every pathogen is resistant to the common antibiotics used in the clinical in different degree. The clinicians should prescribe reasonably according to species of pathogenic bacteria from urinary tract infection and antimicrobial susceptibility test results strictly.