The New Rules Of Oral Medication Of Cefuroxime Predict Clinical Verification In 2014 CLSI Use Of Cefazolin

Objective Through comparative analysis of sensitivity of cefazolin and cefuroxime of patients with simple urinary tract infection caused by Enterobacteriaceae, Verify the new rules of Cefazolin predict the oral medication efficacy of cefuroxime launched by CLSI2014. Providing more treatment options for clinicians to improve the efficacy of anti infection, providing more convenient treatment options for patients to reduce the economic burden.Methods Collect Escherichia coli, Klebsiella pneumoniae, Proteeae mirabilis, from patients with simple urinary tract infection admitted to Affiliated Hospital of North China University of Science and Technology and Tangshan City workers' Hospital from August2014 to March 2016, identify the strains using BD Phoenix-100 and Walk Away96 plus automatic bacterial analyzer. Using WHONET software to analyze the resistance of the Enterobacteriaceae bacteria, Then analysis the consistency of cefazolin and cefuroxime susceptibility by E-test and Kirby Bauer method.Results 1 Distribution of strains and departments:311 cases of patients with simple urinary tract infection caused by Escherichia coli, Klebsiella pneumoniae, Proteeae mirabilis admitted to Affiliated Hospital of North China University of Science and Technology and Tangshan City workers' Hospital from August 2014 to March 2016, 236 strains of Escherichia coli(75.9%), 60 strains of Klebsiella pneumoniae(19.3%), 15 strains of Proteeae mirabilis(4.8%); The pathogenic bacteria were mainly isolated from Department of Urology(25.1%), followed by Nephrology, Geriatrics, ICU, Neurology,Neurosurgery, Neurological intensive ward, respectively accounted for 21.2%?11.3%?6.8%?5.8%?3.5%?2.9%, Out of 36 patients, accounting for 11.6%; 2 Sensitivity results:Escherichia coli, Klebsiella pneumoniae, Proteeae mirabilis, for clinical experience of first-line drugs ampicillin(92.5%?100%?81.8%), cefazolin(71.6%?81.7%?66.7%),sulfamethoxazole(69.6%?67.8%?66.7%), ampicillin/sulbactam(72.1%?86.4%?64.4%)resistance rates were relatively high, Escherichia coli, Klebsiella pneumoniae have a high resistance rates of cefotaxime(75.0%?75.0%)?ceftazidime(65.2%?65.2%)?cefepime(63.7%?71.4%), Levofloxacin of quinolones showed high resistance rate of 76.1%?82.1%?72.7%; low resistance rate on amikacin was 12.6%?29.3%?18.2%, but the relatively high rate of gentamicin resistant belonged to aminoglycosides(61.3%?63.6%?55.6%); To imipenem(2.2% ? 10.7% ? 0.0%), meropenem(2.2% ? 10.7% ? 0.0%),cefoperazone/sulbactam(11.5%?20.7%?8.3%), piperacillin /tazobactam(14.1%?37.1%?9.0%)the bacteria were more sensitive; 3 Validation results of drug sensitivity test: In 311 cases caused by Enterobacteriaceae of simple urinary tract infection patients, cefazolin resistant has 223 and cefuroxime resistance has 221 cases, 2 cases were sensitive strains,Sensitive strains of cefazolin in 83 cases, 82 cases were sensitive to cefuroxime, in 5cases of intermediary cefazolin, 3 cases of cefuroxime were intermediate, 1 cases of resistance, 1 cases of sensitive, 306 cases of Cefazolin and cefuroxime susceptibility results were consistent, 5 cases were inconsistent, Through the ?2 test, P > 0.05, the difference was not statistically significant, Cefazolin can predict the oral medication efficacy of cefuroxime.Conclusions 1 Patients with urinary tract infection caused by Enterobacteriaceae were mainly isolated from Department of Urology, followed by Nephrology, Outpatients,Geriatrics, ICU, Neurology, Neurosurgery, Neurological intensive ward. 2 Escherichia coli, Klebsiella pneumoniae, Proteeae mirabilis, have a high resistant rate of betalactams,sulfonamides, quinolones, To imipenem, meropenem, cefoperazone/sulbactam,piperacillin/tazobactam, the bacteria were more sensitive. 3 E-test and K-B method of cefazolin and cefuroxime susceptibility test results with more than 98%, basically the same results and showed basically the same results of sensitivity of cefazolin and cefuroxime. It suggested that the rule of CLSI is feasible in our country, Cefazolin can predict the oral medication efficacy of cefuroxime. 4.In the treatment of simple urinary tract infections caused by Escherichia coli, Klebsiella pneumoniae and Proteeae mirabilis, Cefazolin sensitive, can also use oral cefuroxime for antimicrobial therapy.