Differences in distribution and drug resistance of pathogens for hospital-acquired urinary tract infections between patients in internal medicine wards and surgical wards

Abstract

Objective To investigate the distribution and drug resistance of pathogens for hospital-acquired urinary tract infections between patients in internal medicine wards and in surgical wards. Methods A total of 586 midstream urine samples were collected from patients in the First Municipal Hospital of Qinhuangdao during January 2012 and December 2014. Vitek 2 Compact system was applied in bacteria identification and drug sensitivity tests. Excel and SPSS 11.5 software were applied for data analysis. Results A total of 661 strains were isolated, in which 404 strains were from internal medicine wards and 257 strains were from surgical wards. Escherichia coli (44.6% vs. 33.1%) and Enterococcus (23.0% vs. 16.3%) infections were more common in the internal medicine wards (χ2=8.620 and 4.309, P<0.05=, while the occurrence of Pseudomonas aeruginosa infection (4.0% vs. 24.5%) was higher in surgical wards (χ2=63.056, P<0.01=. Escherichia coli and Klebsiella pneumonia strains were highly sensitive to piperacillin/tazobactam, cefptetan, amikacin, imipenem, and meropenem, and the sensitivity rates were from 85% to 100.0%. The sensitivity rates of Escherichia coli to ampicillin/sulbactam, levofloxacin and ciprofloxacin were <30%, and strains from surgical wards had lower sensitivity rates to these drug than those isolated from internal medicine wards (χ2=4.987, 4.575 and 5.359, P<0.05=. The sensitivity rates of Klebsiella pneumonia isolated from internal medicine wards to ceftazidime, gentamicin and aztreonam were 68.8%, 60.6% and 69.7%, which were higher than those isolated from surgical wards (36.0%, 32.0%, and 40.0%), and the differences were of statistical significance (χ2=6.068, 4.661 and 5.115, P<0.05=. Pseudomonas aeruginosa strains were highly sensitive to piperacillin/tazobactam and amikacin, and the susceptibilities of strains isolated from surgical wards (98.4% and 96.8%) were higher than those isolated from internal medicine wards (75.0% and 81.3%) (χ2=11.797 and 5.221, P<0.05=. Pseudomonas aeruginosa strains isolated from surgical wards were also highly sensitive to cefepime (92.1%), but the sensitive rate of strains from internal medicine wards was only 37.5%, and the difference was of statistical significance (χ2=24.696, P<0.01=. Enterococcus faecium and Enterococcus faecalis were sensitive to tigecycline, vancomycin and linezolid with the sensitivity rates over 95%. Except quinupristin/dalfopristin and tetracycline, the sensitivities of Enterococcus faecalis to other antibiotics were higher than Enterococcus faecium. Susceptibility of Enterococcus faecium from surgical wards (33.3%) to moxifloxacin was lower than those from internal medicine wards (70.8%), and the difference was of statistical significance (χ2=4.629, P<0.05=. Conclusion There are differences in distribution and antimicrobial susceptibility of pathogens isolated from internal medicine wards and from surgical wards. Key words: Urinary tract infections; Microbial sensitivity tests; Anti-bacterial agents; Pathogens