Urinary Tract Infection(UTI) In Kidney Stone Patients: Analysis Of Bacterial Spectrums And Resistance

Part1: Urinary tract infection(UTI)in kidney stone patients: analysis of Bacterial spectrums and resistance.Purpose: To collect and analyze pathogenic bacteria distribution and drug resistance in kidney stone patients with UTI and to provide the basis of a rational use of preoperative antimicrobial drugs.Method: We collected clinical data of hospitalized patients who were diagnosed with kidney stone and urinary tract infections during January 2009-December 2014 in our center.Pathogenic bacteria and drug resistance were analysed.Results: From the14063 samples analysed,3280(23.3%)were positive for bacterial infection.2037 patients were female and 1173 patients was male.The mean age was 55.0±16.5 years.E.coli was the predominant isolate(47.13%)followed by Enterococcus faecalis(8.47%),Klebsiella pneumoniae(8.35%),Proteus mirabilis(7.10%)and Pseudomonas aeruginosa(4.97%).Frequent pathogenic bacteria in female was E.coli(57.48%),klebsiella pneumoniae(7.55%),Proteus mirabilis(9.30%)and Enterococcus faecalis(6.07%)(7.25%)and Enterococcus faecalis(11.85%)in male.The incidence of Escherichia coli and Proteus mirabilis in female is higher than male(p<0.05),while the incidence of Pseudomonas aeruginosa and Enterococcus faecalis in male is higher than female(p<0.05).Pathogens of kidney stone patients had no significant change in all ages(p>0.05),but the incidence of infection increased with age.E.coli and klebsiella pneumonia were main bacteria in children;E.coli and Proteus mirabilis in young people;E.coli,klebsiella pneumonia and Enterococcus faecalis in middle-aged man;E.coli,klebsiella pneumonia and Enterococcus faecalis in the older.Infections rate of E.coli,klebsiella pneumonia,Proteus mirabilis and pseudomonas aeruginosa was 4.32%,6.47%,3.96%,respectively in 2009 and8.47%,8.47%,respectively,in 2016.Infection incidence of Enterococcus faecalis and Enterococcus faecium was10.79%,3.96%,respectively,in 2009 and 6.85%,1.61%,respectively,in 2016(p<0.05).Resistance rate of E.coli,klebsiella pneumoniae,pseudomonas aeruginosa,Proteus mirabilis for amikacin,piperacillin/tazobactam,imipenem was less than 10%.Resistance rate of acinetobacter baumannii was more than 37.04% for cefepime,imipenem.All of Enterococcus faecalis,Enterococcus faecium,coagulase negative staphylococcus were sensitive to vancomycin and linezolid.Conclusions: our study showed that E.coli,Enterococcus faecalis,Klebsiella pneumoniae,Proteus mirabilisand,Pseudomonas aeruginosa were the predominant uropathogens of urinary tract infection in kidney stone patients.The incidence of Escherichia coli,Klebsiella and Pseudomonas aeruginosa increased,while incidence of enterococci declined in this period.E.coli,klebsiella pneumoniae,Proteus mirabilis and Enterococcus faecalis were main pathogenic bacteria in female and E.coli,klebsiella pneumoniae,Pseudomonas aeruginosa and Enterococcus faecalis in male.E.coli and klebsiella pneumonia were main bacteria in children;E.coli and Proteus mirabilis were main in young people,E.coli,klebsiella pneumonia and Enterococcus faecalis were main in middle-aged man;E.coli,klebsiella pneumonia and Enterococcus faecalis were main in the older.E.coil was predominant isolate.E.coil showed high resistance rates to quinolone and sulfa;while low resistance rates tocarbapenem,aminoglycosides,beta-lactamase inhibitor.Resistance of three generations cephalosporins was increasing.Part2: Patients complicated with serious infection after percutaneous nephrolithotomy(PCNL): analysis of bacterial spectrums and resistancePurpose: To collect and analyze pathogenic bacteria distribution and drug resistance in patients who had serious infection after PCNL in ICU and to provide the basis of a rational use of preoperative antimicrobial drugs.Methods: We collected clinical data of patients who had serious infection after PCNL in ICU during January 2009-December 2014 in our center.Pathogenic bacteria and drug resistance were analysed in preoperative.Results: E.coil was dominating uropathogen accounting for 72.50% of all uropathogen,followed by klebsiella pneumoniae(12.5%)in postoperative patients who had serious infection after PCNL.Resistance of E.coli was more than 50% for ciprofloxacin,levofloxacin,ampicillin and Trimethoprim/sulfamethoxazole.Resistance of E.coli was less than 20% for amoxicillin/clavulanic acid,cefoperazone/sulbactam,Piperacillin/tazobactam.Resistant Resistance of E.coli was less than 10% for amikacin,imipenem.Conclusion: E.coli was the main pathogenic that cause serious infection after PCNL.Very high frequency of resistance to quinolone to penicillin and Trimethoprim/sulfamethoxazole;low resistance to beta-lactamase inhibitor and amikacin was showed by E.coli.