A Retrospective Study Of The Urinary Tract Infection Caused By The ESBLs-Producing Escherichia Coli

ObjectiveThe general information,clinical characteristics,risk factors and drug resistance of patients with urinary tract infection caused by ESBLs-producing Escherichia coli from the Affiliated Hospital of Guilin Medical University during January 2014-December 2017 were collected.To identify the risk factors and drug resistance of urinary tract infection caused by ESBLs-producing Escherichia coli.To provide medical data for for using antibiotics reasonably,for reducing the emergence of drug-resistant strains,and for improving rational drug use rate in patients with urinary tract infection.MethodsTo collect the general situation,clinical characteristics,susceptible factors and drug resistance of patients with urinary tract infection caused by Escherichia coli in the Affiliated Hospital of Guilin Medical College from January 2014 to November 2017.According to whether the Escherichia coli isolated from urine specimens produces ESBLs,it is divided into ESBLs producing group and non producing ESBLs group.We use the SPSS18.0statistics software for data processing,The general situation,clinical characteristics,susceptible factors and drug resistance of patients were statistically analyzed,Comparison of measurement data express in the(x~▁±s)way,Comparison of counting data use the chi square test,Analysis of risk factors use unconditional Logistic regression analysis.Results1.This study collected 136 cases of Escherichia coli infection.,there were30 males(57.33±19.17 years)and 106 females(58.70±16.6 years),of which the non ESBLs-producing Escherichia coli were 71 strains(52.2%),and the ESBLs-producing Escherichia coli were 65(47.8%).2.17 strains of Escherichia coli ESBLs were collected in 2014 year(39.5%),17 strains of Escherichia coli ESBLs were collected in 2015 year(42.5%),15 strains of Escherichia coli ESBLs were collected in 2016 year(65.2%),16 strains of Escherichia coli ESBLs were collected in 2017 year(57.1%).3.The drug resistance rate of the ESBLs-producing Escherichia coli to the ampicillin and the ampicillin/sulbactam was 100%and 61.5%respectively,the drug resistance rate to the cefazolin,cefuroxime,ceftriaxone,ceftazidime and cefepime was 98.5%,95.4%,95.4%,43.1%and 23.1%severally,the drug resistance rate to the left ofloxacin and ciprofloxacin was 67.7%and 66.2%respectively,the drug resistance rate to the aztreonam and the tobramycin was55.4%and 23.1%respectively.The drug resistance rate of the non ESBLs-producing Escherichia coli to the ampicillin and the ampicillin/sulbactam was78.9%and 43.7%respectively,the drug resistance rate to the cefazolin,cefuroxime,ceftriaxone,ceftazidime and cefepime was 36.6%,33.8%,29.6%,11.3%and 7.0%severally,the drug resistance rate to the left ofloxacin and ciprofloxacin was 38.0%and 43.7%respectively,the drug resistance rate to the aztreonam and the tobramycin was 16.9%and 7.0%respectively.The resistance rate of ESBLs producing Escherichia coli to broad-spectrum penicillins(ampicillin,ampicillin Shubatan)and cephalosporins(cefazolin,cefuroxime,ceftriaxone,ceftazidime,cefepime),quinolones(ciprofloxacin,levofloxacin),aztreonam and tobethromycin was significantly higher than that of non ESBLs.Escherichia coli(P<0.05),however,the drug resistance rate to the rateto theimipenem,the ertapenem,themeropenem,the cefoxitin,the piperacillin/tazobactam,the cefoperazone/sulbactam and cefotetan was 3.7%,2.9%,2.2%,13.2%,6.6%,3.7%,8.8%.3.The incidences of the nephrolithiasis,the indwelling catheters and the rate of using cephalosporins in the last 3 months in the ESBLs-producing Escherichia coli group were significantly higher than those in the non ESBLs-producing Escherichia coli group(P<0.05).Multivariate Logistic regression analysis also showed that urinary obstruction,the indwelling catheter and the rate of using cephalosporins in the last 3 months were independent risk factors for the ESBLs-producing Escherichia coli.Conclusions1.The incidence rate of the ESBLs-producing Escherichia coli was high In our nephrology ward.2.The drug resistance rate of the ESBLs-producing Escherichia coli to the broad spectrum penicillins,cephalosporins and quinolones was high,but it is highly sensitive to carbapenem,beta lactamase inhibitor compound and cefamycin.In clinical work,it is recommended to select carbapenems,beta lactamase inhibitors,and cephalosporin antibiotics,which have low rate of resistance to urinary tract infection with ESBLs Escherichia coli.3.The Urinary tract obstruction,the indwelling catheters and the use of thecephalosporin nearly three months were the susceptible factors for the ESBLs-producing Escherichiacoli.