Distribution,Drug Resistance,and Risk Factors of Pathogens Causing Urinary Tract Infections in Patients with Chronic Renal Failure During Hemodialysis
Objective To analyze the distribution,drug resistance,and risk factors of pathogens causing urinary tract infections during hemodialysis in patients with chronic renal failure(CRF).Methods With the retrospective analysis of clinical data from 264 CRF patients who received hemodialysis treatment in hospitals from February 2020 to January 2024,they were divided into the infection group(urine pathogen culture colony count>105 CFU/ml)and the non-infection group,according to the presence or absence of urinary tract infection.The distribution and drug resistance of pathogens in the infection group were analyzed,and multiple Logistic regression analysis was used to identify the risk factors for urinary tract infections in CRF hemodialysis patients.Results During hemodialysis,62 out of 264 CRF patients developed urinary system infections,with an incidence rate of 23.48%.A total of 69 strains of pathogens were isolated from the urine of 62 patients with urinary system infections,including 43 strains(62.32%)of Gram negative bacteria,with Escherichia coli accounting for the highest proportion(21.74%),followed by Klebsiella pneumoniae(14.49%)and Pseudomonas aeruginosa(10.14%);There were 21 strains(30.43%)of Gram positive bacteria,with Enterococcus accounting for the highest proportion(15.94%),followed by Staphylococcus epidermidis(8.70%);Fungi were mainly Streptococcus albicans,with a total of 5 strains(7.25%).The results of drug resistance analysis showed that among Gram negative bacteria,Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa had higher resistance rates to piperacillin,aztreonam,and cephalosporins(60.00%,60.00%,57.13%,respectively);Among Gram positive bacteria,Enterococcus and Staphylococcus epidermidis had higher resistance rates to furazolidone and penicillin,respectively(45.45%and 49.99%,respectively);Among fungi,Streptococcus pneumoniae had a higher resistance rate to fluconazole and itraconazole(40.00%and 60.00%,respectively).The results of single factor analysis showed that there were statistically significant differences between the two groups in gender,age,hemodialysis time,diabetes nephropathy,and serum creatinine(Cr)levels(P<0.05);Multivariate Logistic regression analysis showed that women(OR=5.721,95%CI=1.879～17.418),older age(OR=1.158,95%CI=1.081～1.241),longer hemodialysis time(OR=1.851,95%CI=1.481～2.312),diabetes nephropathy(OR=3.311,95%CI=1.112～9.854),and high Cr level(OR=1.042,95%CI=1.024～1.060)were risk factors for urinary system infection in CRF hemodialysis patients(P<0.05).Conclusion For CRF patients during hemodialysis,with a high incidence of urinary system infection,the pathogens are mainly Gram negative bacteria,and the resistance rate to conventional antibiotics is high.Women,older people,long hemodialysis time,diabetes nephropathy,and high Cr level are the risk factors for urinary system infection.
Urinary system infectionChronic renal failureHemodialysisDistribution of pathogenic bacteriaDrug resistance
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