Distribution of pathogens and clinical diagnostic value of infection biomarkers in uncomplicated urinary tract infection
Objective To analyze distribution of pathogenic bacteria,drug resistance of main pathogenic bacteria and infection markers in urinary system infection,so as to provide experimental ba-sis for the diagnosis and treatment of urinary system infection.Methods The common pathogens and drug resistance of 2 620 patients with urinary system infection treated in 940th Hospital of Joint Logistic Support Force from January 2017 to January 2020 were analyzed.Clinical infection biomarkers of uri-nary sediment white blood cells(WBC),urinary sediment red blood cells(RBC),serum procalcito-nin(PCT),serum interleukin-6(IL-6)and blood routine neutrophil percentage(NEU),the receiver operator characteristic(ROC)curve was analyzed and 846 patients without infection were randomly se-lected as negative control.Results The urinary tract infection accounted for 5.39％(64/1 186)of bloodstream infection patients.The first pathogenic bacteria of urinary tract infection was Escherichia coli 40.08％(1 050/2 620),followed by Enterococcus faecium 13.89％(364/2 620)and Entero-coccus faecalis 6.64％(174/2 620).The lower resistance rate of Escherichia coli was amoxicillin/clavulanic acid,piperacillin/tazobactam,imipenem,ertapenem,amikacin,tobramycin and furantoin,the resistance rates were 10.9％,2.0％,1.4％,0,2.4％and 5.6％respectively.The area AUC under the ROC curve of urine sediment WBC was 0.861 for uncomplicated urinary tract infection,and the sensitivity and specificity were 0.865 and 0.810 for urinary routine WBC ≥10.2/μL,respective-ly.Conclusions The pathogenic bacteria of urinary system infection are complex,the incidence of bloodstream infection is low,and the drug resistance rate of common pathogenic bacteria Escherichia coli is low.Clinicians can guide the rational use of antibiotics according to the epidemiological experi-ence and the results of midstream urine culture drug sensitivity test.The infection biomarkers is only u-rinary sediment WBC,which has high clinical diagnostic value for urinary system infection.
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