Distribution and drug resistance of pathogens isolated from urinary tract infections

Abstract

Objective To investigate the distribution and drug resistance of pathogens isolated from urinary tract infections. Methods A total of 6 262 midstream urine samples were collected from patients in the First Affiliated Hospital of Anhui Medical University during April 2012 and March 2013. MicroScan WalkAway 96 Plus or Vitek 2 Compact system was applied in bacteria identification and drug sensitivity test. WHONET 5.6 was adopted to analyze drug resistance, and IBM SPSS 20.0 was applied to compare resistance rates between isolates from outpatients and hospitalized patients. Results A total of 1 426 strains were isolated, in which 370 strains were gram-positive coccus (25.9%), 942 strains were gram-negative bacilli (66.1%) and 114 strains were fungi (8.0%). Escherichia coli and Klebsiella pneumoniae, Enterococcus faecium and Enterococcus faecalis were the top two among gram-negative bacilli and gram-positive coccus, respectively. The prevalence of extended-spectrum β-lactamases(ESBLs)-producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 60.5%, 51.0% and 30.3%, respectively; About 73.3% of Staphylococcus aureus strains and 86.7% of coagulase-negative Staphylococcus strains were methicillin-resistant. Candida albicans and Candida glabrata were the two most prevalent fungi in urinary tract infections, and they were sensitive to most antifungal agents. Conclusion Gram-negative bacilli, especially Escherichia coli are the most prevalent pathogen in urinary tract infections, and strains are highly resistant to most antibacterial agents, suggesting that antimicrobial resistance monitoring system is needed. Key words: Urinary tract infections; Drug resistance; Bacteria; Fungi