Analysis Of Clinical Characteristics And Pathogenic Bacteria In 232 Patients With Urinary Tract Infection

Objective:To provide a reference for clinical diagnosis and treatment of urinary tract infection patients,the general characteristics,laboratory indicators,pathogen distribution and drug resistance of hospitalized patients were studied and analyzed.Methods:A total of 232 inpatients with urinary tract infection in the Department of Infectious Diseases of the First Hospital of Jilin University from January 2019 to January 2020 were collected.Excel software was used to establish medical records,and the clinical data of these 232 patients were statistically analyzed in the following aspects:（1）Age,gender and underlying diseases of patients;（2）Laboratory indicators of patients: number of white blood cells and neutrophil percentage of blood routine,PCT,CRP,ESR,serum ferritin,cellular immunity,urine routine（including urine number of white blood cells,urine bacteria count,leucocyte enzyme activity,nitrite test）.The relationship between laboratory indicators and age,sex and diabetes mellitus was analyzed;（3）Pathogenic bacteria spectrum and drug sensitivity.Statistical methods SPSS23.0 software was used for statistical processing and analysis of the data.Kolmogorov-smirnov and Shapiro-Wilk were used for normality tests.The measurement data conforming to normal distribution were represented by mean ± standard deviation,and the comparison between groups was performed by independent sample T-test.Median and quartiles were used for non-normal distribution,and the rank-sum test was used for comparison between groups.Counting data were expressed in percentage（%）,and a chi-square test was used for comparison between groups.P < 0.05 was considered statistically significant.Results:（1）Gender and age composition: A total of 232 patients with urinary tract infection were included in this study,including 65 males（28.02%）and 167females（71.98%）,with a median age of 57.5 years and an age range of 18-90 years.There were 110（47.41%）elderly people（≥60 years old）included in this study,including 31（28.18%）males and 79（71.82%）females.There were 122cases（52.59%）of non-elderly（18-59 years old）,including 34 cases（27.87%）of males and 88 cases（72.13%）of females.The proportion of females is significantly higher than that of males.Forty-five patients（19.39%）had diabetes.（2）Serum ferritin in the elderly group was significantly higher than that in the non-elderly group（P=0.005）.Compared with male patients,ESR was significantly increased（P < 0.05）and PCT was significantly decreased（P < 0.05）.The positive rate of leukocyte enzyme in urine of female patients was significantly higher than that of male patients（P=0.033）.（3）The levels of CD3,CD4 and CD8 in cellular immunity in diabetic patients were significantly higher than those in non-diabetic patients（P = 0.011,0.005 and 0.041,respectively）.（4）Analysis of pathogenic bacteria and drug sensitivity: In this study,a total of 90 strains of pathogenic bacteria were detected from 232 patients with a positive rate of 38.79%,including 48 strains（53.33%）of Gram-negative bacteria,mainly 38 strains（42.22%）of Escherichia coli.There were 34 Gram-positive strains（37.78%）,and 22 strains（24.44%）were Enterococcus faecium.There were 8 strains of fungi（8.89%）,mainly 6 strains of Candida（6.66%）.Among gram-negative bacteria,escherichia coli had high resistance to ampicillin,ciprofloxacin,piperacillin,cefuroxime,ceftriaxone and levofloxacin,with resistance rates ranging from 71.05 to 89.47%.They were highly sensitive to meropenem and imipenem,and the drug resistance rate was 0.Among grampositive bacteria,Enterococcus faecium had higher resistance to ciprofloxacin,levofloxacin,ampicillin,high level of streptomycin and penicillin,and the resistance rate was 77.27-95.45%.It was highly sensitive to tigecycline,vancomycin and linezolid,and the drug resistance rate was 0.Conclusion:（1）Urinary tract infection patients were mainly female.Compared with male patients,some inflammatory indicators such as ESR and urinary leucocyte enzyme activity were significantly higher in female patients.（2）The main pathogenic bacteria of Gram-negative bacilli was Escherichia coli,which had high resistance to quinolones and ampicillin.It was sensitive to piperacillin/tazobactam,amikacin and cefepime,and was highly sensitive to carbapenems.（3）The main pathogenic bacteria of Gram-positive cocci was Enterococcus faecium,which had high resistance to penicillin,quinolones and ampicillin.It is highly sensitive to tigecycline,vancomycin and linezolid.（4）For patients whose urine culture has not returned,it is recommended to select piperacillin/tazobactam,amikacin and cefepime.because they are high sensitivity to the most common pathogen of urinary tract infection,Escherichia coli.And the treatment plan was adjusted in time according to urine culture and drug sensitivity.