Clinical Analysis Of Diabetes Patients With Urinary Tract Infection

Objective: To compare the distribution of pathogenic bacteria and drug resistance in patients with simple urinary tract infection and diabetes mellitus complicated with urinary tract infection,and to provide theoretical basis for the selection of appropriate antibiotic drugs for patients with diabetic urinary tract infection.Urinary tract infection in patients with or without diabetes mellitus(DM)were selected,and to explore the risk factors of diabetes mellitus complicated with urinary tract infection.Methods:(1)Bacteriological analysis of diabetes mellitus complicated with urinary tract infection: By retrieving all urine culture positive patients admitted in the endocrinology department of the First Affiliated Hospital of Nanhua University from July 2014 to July 2016,in strict accordance with the inclusion and exclusion criteria,305 samples were included in the study.Simple urinary tract infection were 212 samples,and with diabetes mellitus were 93 samples.In strict accordance with the laboratory and manual operation process to detect the pathogens contained in urine samples and Escherichia coli resistance to common antibiotics,the distribution of pathogenic bacteria and the resistance of common bacteria were compared.(2)To explore the risk factors of diabetes mellitus complicated with urinary tract infection: In July 2014-2016 July hospital endocrinology hospitalized patients with diabetes,163 diabetes patients with complete information were filtered,which Including 66 cases of diabetic patients with urinary tract infection and non-urinary tract infection in patients with diabetes in the same period 97 cases.Obtaining the Age,sex,urine sugar status,glycosylated hemoglobin,creatinine,glomerular filtration rate and other information.The risk factors of diabetes mellitus complicated with urinary tract infection were analyzed by univariate and multivariate logistic regression analysis.Results:(1)In 93 patients with diabetes-positive urine culture,93 strains of pathogens are isolated from urine samples(89 strains of Gram-negative bacteria,2 strains of Gram-positive bacteria,2 strains of fungi);The first three pathogens are Escherichia coli(67,72.04%),Klebsiella pneumoniae(12,12.09%)and Staphylococcus aureus(12,12.09%).(2)According to comparing the urinary tract infection in patients with diabetes merging urinary tract infections in patients in urine specimens,Found that the most important pathogens is Escherichia coli(the proportion was 72.04% and 60.32%),and followed by Klebsiella pneumoniae(12.90% and 8.96%)and Staphylococcus aureus(2.15% and 1.89%),but there is no significant difference between the two groups(P> 0.05).(3)In the urine specimens of Diabetes merging urinary tract infection and urinary tract infection in patients,Escherichia coli resistance to the phenomenon are more common,especially for ciprofloxacin,ampicillin / sulbactam,ceftriaxone,cefuroxime,sulfamethoxazole resistance of up to 50% or more.However,there is no significant difference in the drug resistance of the two antibiotics(P> 0.05).(4)In diabetic patients,the rate of urinary tract infection is 28.62%.Univariate analysis find that compared with patients without urinary tract infection,diabetes merging urinary tract infection in patients follow more women,Higher mean age,longer course of disease,higher rate of indwelling catheter,higher bed rest rate,lower average GFR,higher urinary protein positive rate,and the above factors are statistically significant(P<0.05).however,there is no significant difference in body mass index(BMI),Hb A1 c,urine sugar and creatinine between the two groups(P> 0.05).Multivariate logistic regression analysis show that elderly(OR=3.89,95%CI=1.11-11.12),female(OR=4.46,95%CI=1.44-13.83),urine protein positive(OR=6.92,95%CI=2.43-19.69),and duration(OR=3.61,95%CI=2.21-18.12)are independent risk factors for diabetes mellitus complicated with urinary tract infection.Conclusion:(1)Escherichia coli is a major pathogen in diabetic merging urinary tract infection patients;in the patients with urinary tract infection,the presence of diabetes on the distribution of pathogens and antibiotic resistance has no effect.(2)The elderly,female,urine protein positive,and duration are independent risk factors for diabetes mellitus complicated with urinary tract infection.