Analysis of the spectrum and antibiotic resistance of uropathogens in vitro: results based on a retrospective study from a tertiary hospital.
BACKGROUND
Antibiotic resistance of uropathogens in urinary tract infections (UTIs) is increasing worldwide. This study aimed to compare the spectrum and antimicrobial resistance of uropathogens in community-acquired UTIs (CAUTIs) and nosocomial-acquired UTIs (NAUTIs) at a tertiary hospital in China.


METHODS
Retrospective analysis of uropathogens from UTI patients was performed at Zhong Da Hospital.


RESULTS
A total of 1129 strains was isolated from 653 community-acquired and 476 nosocomial-acquired infections. Escherichia coli was the most common uropathogen, accounting for 55.9% of the CAUTIs and 27.1% of the NAUTIs. Among the CAUTIs, Escherichia coli was followed in prevalence by Enterococcus spp (12.9%) and Proteus mirabilis (3.7%). Among the NAUTIs, Escherichia coli was followed by Enterococcus spp (15.3%) and Klebsiella pneumoniae (6.9%). The proportion of fungi in the NAUTIs (23.7%) was higher than that in the CAUTIs (3.1%) (P < .05). Extended-spectrum β-lactamase-producing strains of E coli accounted for 70.6% of the NAUTIs and 47.3% of the CAUTIs. Carbapenems, amikacin, and nitrofurantoin were active agents against E coli. The resistance rates of E coli to cephalosporins, ampicillin, ampicillin/sulbactam, quinolones, and gentamicin were higher in the NAUTIs than in the CAUTIs (P < .05).


CONCLUSIONS
The distribution of species was different between CAUTIs and NAUTIs. Higher antibiotic resistance rates were observed in the NAUTIs than in the CAUTIs.
Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing City, Jiangsu Province, China. mmkkll@hotmail.com
Kun Ling
KL
Ma
Chang Xian
CX
Wang
D039903:Actinobacteria / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002681:China; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000382:microbiology*; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D016983:Enterococcus / Q000187:drug effects; D004926:Escherichia coli / Q000187:drug effects; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy; D007711:Klebsiella pneumoniae / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011513:Proteus mirabilis / Q000187:drug effects; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology*
D000900:Anti-Bacterial Agents