Characteristics and Drug Resistance of Pathogens in Urinary Tract Infection Patients Complicated with Urinary Calculi
2020
Main objective is to explore the characteristics, drug resistance, and risk factors of pathogens in urinary tract infection patients complicated with urinary calculi. A total of 417 patients with urinary calculi who were treated in our hospital from January 2017 to December 2019 were enrolled in this study, including 234 patients with urinary tract infection and 183 patients without urinary tract infection. The midstream urine of 234 patients with urinary tract infection were cultured and used in the drug sensitivity test. Univariate and multivariate logistic regression analysis was used to analyze the risk factors of postoperative urinary tract infection in patients with urinary calculi. A total of 624 strains of pathogens were isolated from the urine samples of 234 patients with postoperative urinary tract infection, of which 386 strains were gram-negative bacteria (61.86 %), 169 strains were gram-positive bacteria (27.08 %), and 69 strains were fungus (11.06 %). In the drug resistance test, the resistance rates of Staphylococcus aureus to tetracycline, rifampicin, and levofloxacin, and the resistance rate of Enterococcus faecium to levofloxacin was low. Enterococcus faecalis had the lowest resistance rate to levofloxacin, followed by azithromycin and gentamicin. The resistance rates of Staphylococcus epidermidis to levofloxacin and vancomycin were low and the resistance rate to erythromycin was 100.00 %. The resistance rate of Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, and Proteus mirabilis to meropenem and amikacin, and the resistance rate of Klebsiella pneumoniae and Proteus mirabilis to etilmicin and ceftriaxone were low. Univariate analysis showed that the postoperative urinary tract infection in patients with urinary calculi was related to the age, operation time, postoperative indwelling catheter time, stone size, and preoperative prophylactic use of antibiotics. Multivariate logistic regression analysis showed that the age (≥65 y old), operation time (≥60 min), postoperative indwelling catheter time (≥7 d), and no preoperative prophylactic use of antibiotics were the risk factors of postoperative urinary tract infection in patients with urinary calculi. Patients with urinary calculi were prone to urinary tract infection after the operation. The main pathogens of infection were gram-negative bacteria and gram-positive bacteria, and they were resistant to some antibiotics. Antibiotics should be treated reasonably according to the risk factors of urinary tract infection and the results of the drug sensitivity tests to avoid further aggravation of bacterial drug resistances.
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