142 Cases Of Hospitalized Patients Retrospective Study Of Diagnosis And Treatment Of Urinary Tract Infection

Urinary tract infection(UTI) is one of the most common diseases of the urinary system. The patients who are hospitalized in the Nephrology and Endocrinology unit of our hospital almost are elder and suffered from diabetes and chronic kidney disease (CKD). Thus UTI is one of the common infection diseases in the Nephrology and Endocrinology unit. Antibiotic therapy is the mainly treatment for UTI. The majority of the patients respond well to it. That the patients are complicated by all kinds of complex factors leads to the result that single antibiotic therapy ofen cannot achieve the effect. With the widely use of antibiotic, glucocorticoid and immunosuppressant,the bacterial spectrum of pathogenic bacterium causes UTI is changing gradually. The antimicrobial resistance of bacteria also increases accordingly. Traditional Chinese Medicine therapy has a larger advantage. Chinese medicine cooperates antibiotic treatment can obtain good curative effect.But UTI is ofen ignored by clinician. The lack of understanding to UTI and the non-standard treatment to UTI result in the relapse of illness and continuing difficult more.The article is to analyze the clinical features of142patients with urinary tract infection who were hospitalized in the Nephrology and Endocrinology unit by means of a retrospective study to them. Meanwhile we investigate the relationship of the complicating factors and TCM syndromes. We also get the statistics of the distribution of pathogenic bacteria and the situation of bacterial resistance. The purpose of this study is to show the treatment to UTI in the past and offer help to the treatment to UTI in the future.After recording and analyzing the general information,the clinical symptoms,the assistant examination and the treatment of142patients with urinary tract infection,we get the result:①The female had a higher incidence of UTI than the male. The incidence was increasing with age. Bacterial urinary tract infection,lower urinary tract infection and complicated urinary tract infection were common in these patients. The top5of combined factors weree menopause,diabetes,CKD,gynecological inflammation and prostate enlargement.②There were42patients with asymptomatic bacteriuria(ASB).36cases received antibiotic therapy, and8cases of them had a double infection finally. Most of the patients with ASB responded well to antibiotic therapy. But the part of them didn’t respond well,even had a double infection.③There were88patients which belonged to syndrome of intermingled deficiency and excess.We found out that diabetes,CKD, menopause and pro antibiotic therapy were positively correlated with this TCM syndrome.The possibility of occuring this TCM syndrome of the patients who suffered from diabetes was2.410times than the ones without diabetes. The numerical value of CKD,menopause and pro antibiotic therapy were7.700,3.822and3.042. Diabetes,CKD,menopause and pro antibiotic therapy were the risk factors of syndrome of intermingled deficiency and excess.④Gram-negative bacillus were the most common pathogenic bacterium in142patients,and the second were Gram-positive cocci.The top3of pathogenic bacterium were escherichia coli(37.43%)，enterococcus (22.91%), klebsiella(6.15%). The drug resistance to ampicillin of the above three pathogenic bacterium were85.07%-100%.They also resisted to cefuroxime axetil and cefotaxime.But they were sensitive to cefoxitin,levofloxacin，Cefoperazone, imipenem and meropenem. There were32bacterial strains which produced ESBLs among of67escherichia coli. The rate of producing ESBLs was47.8.There were2bacterial strains which produced ESBLs among of11klebsiella.The rate of klebsiellawas18.2%. The total rate of Gram-negative bacillus was31.2%.