Distribution and drug resistance of pathogens in urinary tract infections in Zhoupu area, Shanghai during 2016 to 2020

doi:10.16150/j.1671-2870.2021.01.015

Abstract

Abstract:

Objective: To study the distribution and drug resistance of pathogens in urinary tract infections(UTI), and to provide evidence for rational treatment of the disease. Methods: The results of bacterial culture from morning clean-catch mid-streamurinein the patients with UIT during July 2016 to June 2020 were retrospectively analyzed to determine the distribution and drug resistance of pathogens. Result A total of 3 543 specimens were collected, 810 strains of pathogens were isolated, and the positive rate was 22.9%, including 558 strains of Gram-negative bacteria (68.9%), 113 strains of Gram-positive cocci (14.0%), 128 strains of Mycoplasma(15.8%), 11 strains of fungi(1.4%). The majority of bacteria strains were Escherichia coli (337 strains, 41.6%) and Klebsiella pneumoniae (67 strains, 8.3%). Ureaplasma urealyticum(UU) accounted for 10.6% (86 strains) inisolated mycoplasma. Escherichia coli and Proteusisolates were sensitive to aminoglycoside and carbapenem antibiotics and the resistant rates were lower than 5%; Klebsiella pneumoniae was resistant to ceftriaxone and levofloxacin and its′ resistant rates were 58.3% and 55.2%, respectively.All Enterococci strains were resistant to penicillin, ampicillin, gentamicin, and levofloxacin, which had higher resistance rates than those in Enterococcus faecalis; Enterococcus faecalis had high resistant rates to levofloxacin and moxifloxacin(73.3% and 64.4%, respectively). Staphylococcus aureus and Enterococcus were sensitive to sulfonamides, glycopeptides and common broad-spectrum antibiotics, and the resistant rates were lower than 5%. The drug resistant rate of UU to ciprofloxacin was 69.9%, and UU was sensitive to both minocycline and doxycycline. Conclusions: The majority of pathogens isolated from UTI patients in Zhoupu District of Shanghai is Gram-negative bacilli, which shows different degree of resistance to common antibiotics. Therefore, the regular monitoring of UTI pathogenic bacteria is important to determine how to choose antibiotics in clinical practice.

Key words: Urinarytract infection, Pathogens, Antibacterial drugs, Drug resistance

CLC Number:

R372

KONG Nana, ZHANG Peiyan, YANG Deping, JIN Huimin, ZHENG Jianghua. Distribution and drug resistance of pathogens in urinary tract infections in Zhoupu area, Shanghai during 2016 to 2020[J]. Journal of Diagnostics Concepts & Practice, 2021, 20(01): 93-97.

Figures/Tables 4

References 19

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病原体	株数(n)	构成比（%）
革兰阴性杆菌
大肠埃希菌	377	41.6
肺炎克雷伯菌	67	8.3
变形杆菌	41	5.1
铜绿假单胞菌	21	2.6
鲍曼不动杆菌	15	1.9
阴沟肠杆菌	9	1.1
嗜麦芽窄食单胞菌	12	1.5
产气肠杆菌	5	0.6
其他	11	1.4
革兰阳性球菌
粪肠球菌	45	5.6
屎肠球菌	21	2.6
金黄色葡萄球菌	13	1.6
腐生葡萄球菌	11	1.4
无乳链球菌	10	1.2
溶血葡萄球菌	6	0.7
表皮葡萄球菌	4	0.5
其他	3	0.4
支原体
解脲支原体	86	10.6
泌尿支原体	31	3.8
人型支原体	11	1.4
真菌
光滑念珠菌	5	0.6
白念珠菌	6	0.7
合计	810	100

抗生素	大肠埃希菌(n=377)		肺炎克雷伯菌(n=67)		变形杆菌(n=41)
抗生素	耐药株数（n）	耐药率（%）	耐药株数（n）	耐药率（%）	耐药株数（n）	耐药率（%）
氨苄西林	267	70.8	-	-	28	68.2
氨苄西林/舒巴坦	142	37.7	34	50.7	20	48.7
哌拉西林/他唑巴坦	4	1.1	14	20.9	2	4.9
头孢曲松	150	39.8	39	58.3	13	31.7
氨曲南	107	28.4	28	41.8	9	22.0
阿米卡星	11	2.9	11	16.4	2	4.9
左氧氟沙星	191	50.7	37	55.2	20	48.8
复方新诺明	170	45.1	21	31.3	20	48.8
头孢他啶	73	19.4	26	38.8	9	22.0
头孢吡肟	53	14.1	8	11.9	4	9.8
亚胺培南	10	2.7	21	31.3	0	0
庆大霉素	86	22.9	22	32.8	7	17.1
呋喃妥因	48	12.7	28	41.8	4	9.8

抗生素	粪肠球菌（n=45）耐药	屎肠球菌（n=21）耐药	金黄色葡萄球菌（n=13)耐药
青霉素	16（35.6）	21（100）	9（69.2）
苯唑西林	0（0）	0（0）	9（69.2）
氨苄西林	16（35.6）	21（100）	0（0）
哌拉西林/他唑巴坦	0（0）	0（0）	0（0）
庆大霉素	18（40.0）	13（61.9）	7（53.8）
左氧氟沙星	33（73.3）	21（100）	6（46.2）
克林霉素	0（0）	0（0）	7（53.8）
利奈唑胺	0（0）	0（0）	0（0）
万古霉素	0（0）	0（0）	0（0）
呋喃妥因	0（0）	5（23.8）	0（0）
红霉素	2（4.4）	3（14.3）	4（30.8）
莫西沙星	29（64.4）	16（76.2）	4（30.8）
复方新诺明	0（0）	0（0）	0（0）
利福平	0（0）	0（0）	0（0）
磷霉素	0（0）	0（0）	0（0）
链霉素	22（48.9）	3（14.3）	0（0）

抗生素	UU（n=83)
抗生素	耐药株数	耐药率
米诺环素	0	0
强力霉素	0	0
四环素	3	3.6
交沙霉素	5	6.0
氧氟沙星	20	24.1
红霉素	23	27.7
克拉霉素	23	27.7
阿奇霉素	23	27.7
罗红霉素	25	30.1
司巴沙星	25	30.1
左氧氟沙星	28	33.7
环丙沙星	58	69.9