Abstract:

Objective: To investigate the distribution and drug resistance of pathogens in elderly women with diabetes mellitus complicated with urinary tract infection in Dapuqiao community, Huangpu District, Shanghai, and to study the etio-logical information of patients with different treatment experiences in the region, so as to provide a guidance for clinical treatment. Methods: From June 2016 to June 2018, 214 elderly women with diabetes mellitus and leukocyte positive urine samples were collected for bacterial identification and drug sensitivity test. The patients were divided into community health center group (group A) or general hospital group (group B) according to their previous therapeutic experience whether had been treated in community health center or in general hospital. The basic situation of the two groups and the composition of pathogenic bacteria isolated from clean midstream urine samples were compared and analyzed with the results of drug susceptibility. Results: ① There were 166 patients with pathogenic bacteria, of which 94 were in group A and 72 were in group B. The top five dominant pathogens in group A were Escherichia coli, Proteus, Klebsiella pneumoniae, Enterococcus, Streptococcus agalactiae and Pseudomonas aeruginosa, while the top five pathogens in group B were Escherichia coli, Klebsiella pneumoniae and Enterococcus cloacae, Enterococcus, Proteus and Acinetobacter loffei. No fungus was detected in both groups; ② Drug analysis showed that the drug resistance rate to Escherichia coli exceeded 50%. In group A, the drug resistance was: ampicillin (77.55%), levofloxacin (58.33%) and ciprofloxacin (58.00%); in group B was: cefuroxime (97.73%), ampicillin (97.62%), ceftazidime (88.64%), cefepime (82.93%), ciprofloxacin (82.93%), levo-floxacin (82.22%), compound neomycin (51.16%). ③ The resistance of Escherichia coli to penicillin and its enzyme inhibitors and second generation, third generation, third generation of cephalosporins (including Ceftazidime, Cefepime, Cefuroxime and Cefoxitin) in Group B was significantly higher than that of group A (P<0.01). Both groups were resistant to ampicillin, ciprofloxacin and levofloxacin, but the degree of resistance was 58% in group A and 82% in group B. There was statistically significant difference between the two groups (P<0.05). Conclusions: Escherichia coli is the main pathogen in elderly women with diabetes mellitus complicated with urinary tract infection. However, there are differences in the order of dominant pathogens and drug resistance between patients with different treatment experiences.

Key words: Diabetes mellitus, Urinary tract infection, Distribution of pathogenic bacteria, Survey of drug resistance