Analysis Of Related Factors Of Urinary Tract Infection In Elderly Patients And Pathogenic Bacteria Distribution In Cadre Ward In Our Hospital

Objective:To explore related factors of elderly patients with urinary tract infection,pathogenic bacteria distribution and pathogen resistance in Cadre ward in our hospital,provide the risk factors of urinary tract infection,pathogenic bacteria distribution characteristics and pathogenic bacteria resistance rate for the clinicians,and provide individualized administration according to the develop effective control and prevention measures and clinical rational drug use.Methods: The 1:1 case-control study,conducted a questionnaire survey and review of cases collected the clinical data included basic situation,living habits and biochemical results,urine culture and drug test,identification of pathogenic bacteria distribution,pathogens sensitivity to antimicrobial agents.Application of JMP Pro 10.0 software for two independent samples of single factor analysis and pathogenic bacteria resistance rate,use software SPSS17.0 to whether suffering from urinary tract infection(in case group=1 and the control group=0)as the dependent variable,the single factor analysis statistical significance(P<0.05)variables as independent variables in conditional pairing multivariate Cox regression analysis,screening out with the risk factors of clinical significance.Results: There are 160 peoples each group respectively,a total of 320 questionnaires were distributed,320 copies were recovered,the recovery rate was 100%.Single factor analysis showed that the carrier,the daily amount of water,daily outdoor activity,vegetable intake,cleaning the perineum,times of hospitalization,bed and catheterization,and suffering from the disease,the number of people with the disease(stroke),within a year the number of antibacterial drugs,immunosuppressive agents and use of hormones,non steroidal anti-inflammatory drugs and other factors were statistically significant(P<0.05);and the income,education level,body mass index,smoking history,drinking history were not statistically significant(P>0.05);multi factor analysis showed that the daily amount of water,vegetable intake,disease frequency,bedridden,indwelling catheter,the use of antibacterial drugs,immunosuppressive agents and use of hormones,corticosteroids,daily outdoor activity,perineal cleaning times,indwelling catheter is the risk for urinary tract infection factors(odds ratio is greater than 1)and non steroidal anti-inflammatory drugs is analysis results in no statistical significance,is a protective factor;the distribution of pathogenic bacteria collected urine samples of 160 cases,among them 4 cases of early application of anti infection treatment,no pathogenic bacteria were cultured,156 specimens were examined with the isolation and identification of bacteria and drug sensitivity test,which 5 cases were isolated and identified out two kinds of pathogenic bacteria infection,so total of 30 seed,161 strains of pathogenic bacteria were identified.Gram negative bacteria identified was the highest,among them Escherichia coli infection rate were most,accounted for 54.04%,followed by pneumonia Klebsiella pneumoniae(4.97%)Proteus bacteria(4.5%);pathogenic bacteria resistance rate,gram negative bacilli to meropenem,no drug resistance,and to cephalosporins cefotetan,butylamine card kanamycin resistance rate was the lowest,followed by piperacillin / he tazobactam,imipenem,ceftazidime cefepime,cefotaxime ceftazidime and aztreonam.Gram positive bacteria to vancomycin,tigecycline and linezolid had no resistance,and nitrofurantoin resistance rate,Enterococcus drug resistance rate was 66.67%,Staphylococcus epidermidis and Enterococcus drug resistance rate was 0%;gram negative bacteria were identified in 87 strains of Escherichia coli isolated pathogenic bacteria identification and drug sensitivity test in which,33 strains producing ESBLs,production rate of 37.93%,Klebsiella pneumoniae identified 8 strains,which was 12.5%,Klebsiella oxytoca identified 2 strains produced ESBLs;Drug sensitivity test results and clinical experience of anti infection treatment sensitivity is 26.67%,intermediary 26.67%,40.00% resistant,incompatible 6.67%;general in the clinical treatment of urinary tract infection application of quinolones accounted for the first(producing ESBLs and non ESBLs are included on the inside),followed by cephalosporins.Conclusion: risk factors lead to urinary tract infection are occupation,stroke,suffering from disease number,lying in bed for a long time,indwelling catheter,use of antimicrobial drugs,immunosuppressive agents,hormones,drugs,daily volume of outdoor activities,perineal cleaning frequency,indwelling urinary catheter etc;diabetes and prostate hyperplasia study no statistically significance,which may be the research object of this research is less,narrow area lead to biased results,so the need for further research.The pathogenic bacteria of urinary tract infection were mainly dominated by Gram negative bacilli,followed by Gram positive bacteria and fungi.The urinary tract infection caused by Escherichia coli was the most common,followed by Klebsiella pneumoniae,which produced a strong rate of ESBLs,so the combination of drug sensitivity test results in clinical drug resistance treatment.