Objective To analyze clinical characteristics and drug resistances with urinary tract infections caused by extended spectrum β-lactamase producing Escherichia coli and provides sug-gestions for rational use of antibiotics.Methods The midstream urine of 6 620 patients with suspected urinary tract infection from the Second Central Hospital of Baoding City from January 2020 to June 2022 was collected for bacterial culture,and bacterial identification and drug sensitivity test were con-ducted by automatic microbial identification instrument and matching card.Results Eight hundred and forty-five strains of pathogens were detected in 6 620 urine culture samples,the detection rate was 12.8％.Among them,there were 529 strains of gram-negative bacteria(62.6％),135 strains of gram-positive bacteria(16.0％)and 181 fungi(21.4％).The top 3 bacteria with the highest detec-tion rate were Escherichia coli(411),Klebsiella pneumoniae(58)and Enterococcus faecalis(50).Urology and nephrology accounted for 28.4％and 13.0％of the departments,respectively.A total of 255 ESBLs-producing Escherichia coli strains were detected.The drug resistance rate of ESBLs-produ-cing Escherichia coli to ampicillin,piperacillin,cefazolin,cefotaxime and ceftriaxone was above 80％,which was significantly higher than that of non-ESBLs-producing Escherichia coli(P＜0.05).It is sensitive to carbapenem antibiotics(imipenem,meropenem)and aminoglycoside antibiotics(ami-kacin).In the combined analysis of the two indexes of urine routine,no matter in ESBLs positive or negative Escherichia coli,the combined detection of leukocyte and nitrite had higher sensitivity and specificity than the single index,and the positive predictive value and negative predictive value were more than 80％.In the single index analysis,nitrite has higher sensitivity in ESBLs-positive Esche-richia coli.When urine pH was less than 6.0,the proportion of ESBLs-producing Escherichia coli was 34.9％.Non-ESBLs-producing Escherichia coli accounted for 52.87％.Conclusions The compre-hensive analysis of white blood cells and nitrite in urinary routine detection is rapid,has the good sen-sitivity and specificity,is suitable for urinary tract infection,especially in the early diagnosis and screening of the Escherichia coli.Experience selection can cover ESBLs and avoid the production of multiple resistant bacteria.
万方数据
维普
