Analysis Of Clinical Characteristics And Pathogenic Bacteria Of 450 Patients With Community-acquired Simple Urinary Tract Infection And Urosepsis

Objective:To analyse the clinical characteristics,pathogenic bacteria and their drug resistance for the hospitalized patients with community-acquired and simple urinary tract infection and urosepsis in our region,and to explore features and developing trends of the community-acquired urinary tract infection in this region.Methods:The clinical data of inpatients with community-acquired and simple urinary tract infection and urosepsis hospitalized in the urinary department of our hospital from January 2014 to December 2019 were collected,and statistical analysis was performed on the following aspects:?age and gender distribution of patients;?the patients'illness condition,nutritional status and their relationship with age and gender;?pathogenic bacteria spectrum and drug sensitivity.Results:?Gender and age composition:A total of 450 eligible cases were enrolled in this study,including 250 males and 200 females.According to the ages,189 cases belonged to young age group(?44 years),114 cases belonged to middle-aged group(45-59 years),109 cases belonged to young old age group(60-74years)and 38 cases belonged to old age group(?75 years).There was a significant difference in gender composition among the different age groups(P<0.001).The proportion of female was significantly higher than that of male in the young age group(P<0.001).?Illness condition and its relationship with age and gender:the highest body temperature of the young group was significantly higher than that of other groups(all P<0.05),and there was no significant difference in the highest body temperature between the male and female groups(P=0.511).According to the white blood cell count,there was no significant difference among the different age groups(P=0.588),while the white blood cell count of the male group was significantly higher than that of the female group(P<0.001).We also drew a conclusion:the older the age,the longer the relative hospital stay(P=0.035);and the hospital stay of the male was significantly longer than the female's(P=0.003).?Nutrition status and their relationship with age and gender:the body mass index(BMI)of the young group was significantly lower than that of other age groups(all P<0.001),of which the young female group's BMI was the lowest,and there was no significant difference between different genders in all age groups(P=0.050).For the hemoglobin levels,there was no significant difference among the 4 age groups(P=0.275),while the male's hemoglobin level was significantly higher than the female's in all ages(P<0.001),and the young group's hemoglobin level was the lowest in the female patients.For the albumin levels,there was no significant difference among the all age groups(P<0.001),of which the albumin level of the young male group was the highest,the young female group's and all elderly groups'were relatively low;and there was no significant difference between the different gender groups(P=0.112).For the serum prealbumin levels,there was no significant difference among the all age groups(P=0.020),of which the prealbumin level of the young female group was the lowest;and the male group's prealbumin level was significantly higher than that of the female(P=0.006).?Pathogenic bacteria spectrum and drug sensitivity analysis:242 strains of pathogenic bacteria were obtained from urine culture in 450patients,and the urine culture positive rate was 53.8%.The main bacteria consisted of205 strains of E.coli(84.7%),9 strains of Enterococcus faecalis(3.7%),and 8 strains of Klebsiella pneumoniae(3.3%);there was a significant difference in the distribution of bacterial species between male and female groups(P=0.031),in which the proportion of G~+bacteria obtained in the male group was significantly higher than that in the female group.In the 18 strains of G~+bacteria,the sensitivity+intermediary rate to tigecycline and vancomycin was all up to 100%,the sensitivity+intermediary rate to quinolone in the later 3 years(2017-2019)was all?80%,Showed a significant upward trend compared with the former 3 years(2014-2016)(all<40%),but there was no significant statistical difference.In the 217 strains of G~-bacteria,they were all100%sensitive to imipenem,piperacillin-tazobactam,and the sensitivity+intermediary rate to ampicillin was<30%,and the sensitivity+intermediary rate to aztreonam and levofloxacin in the later 3 years had a significant downward trend compared with the former 3 years(all P<0.05).As for ESBLs-producing Escherichia coli and Klebsiella pneumoniae,the proportion of ESBLs(+)bacteria in the later three years was significantly higher than that in the former three years(P=0.013).Conclusion:Male and young female with poor nutrition status were more common in severe patients with community-acquired and simple urinary tract infection in our region.Escherichia coli was still the most common pathogenic bacteria,and it is resistance to aztreonam and levofloxacin had been increasing gradually.