An Analysis of the Distribution and Drug Resistance of Pathogenic Bacteria in Urine Culture of a Tertiary Hospital in Chengdu Area from 2019 to 2022
Objective To collect and analyze the distribution and drug resistance of pathogenic bacteria in 13 539 urine culture samples from a tertiary hospital in Chengdu area from 2019 to 2022,and to provide useful references for empirical drug selection in clinical practice before the issuance of urine culture drug sensitivity results.Methods We collected urine culture samples from outpatient and inpatient settings from 2019 to 2022 for the current study.For samples with positive urine culture,a fully automated bacterial analyzer was used for bacterial identification and drug sensitivity analysis.The drug sensitivity results were interpreted according to the Clinical and Laboratory Standards Institute(CLSI)standards in the United States.WHONET5.5 was applied to analyze the distribution of pathogenic strains and data on antibiotic resistance.Results 2 586 strains of pathogenic bacteria were isolated from 13 539 urine culture samples,with a positive culture rate of 19.09％.Among them,the top five pathogenic bacteria were as follows:1337 strains of Escherichia coli(46.81％),168 strains of fungi(6.5％),136 strains of Enterococcus faecalis(5.26％),135 strains of Enterococcus faecalis(5.22％),and 133 strains of Klebsiella pneumoniae(5.14％);The population with urinary tract infections was mainly concentrated in patients over 40 years old,and the number of infected women was greater than that of men;Drug sensitivity data showed that the resistance rate of Gram-negative Escherichia coli to ampicillin was over 65％,while the resistance rate of Klebsiella pneumoniae to ampicillin was below 3％.Both Escherichiacoli and Klebsiella pneumoniae were 100％sensitive to cefotaxime/potassium clavulanate and cefotaxime/potassium clavulanate;Among Gram-positive bacteria,Enterococcus faecalis and Enterococcus faecalis were mainly resistant to aminoglycosides and penicillin drugs,such as gentamicin and ampicillin,but there were significant differences in resistance between them.For example,ampicillin was almost 100％resistant to Enterococcus faecalis,while it was relatively low to Enterococcus faecal is.Conclusion The main pathogenic bacteria causing urinary tract infections in clinical patients at a tertiary hospital in Chengdu area are Gram-negative bacteria,with Escherichia coli ranking the highest.In addition,it is important to note the increase in fungal infections and the high proportion of drug-resistant strains in the Enterococcus genus.Therefore,in the clinical diagnosis and treatment process,appropriate antibiotics should be selected based on urine culture and drug sensitivity test results,and effective treatment should be carried out while strengthening the prevention and control of drug-resistant bacteria.
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