Clinical Situations of Bacteriology and Prognosis in Patients with Urosepsis

الملخص EN

Background.

Urosepsis and septic shock are a critical situation leading to a mortality rate up to 30% in patients with obstructive diseases of the urinary tract.

Aim.

To analyze the bacterial distribution and drug resistance of pathogenic bacteria in patients with urosepsis and to provide a basis for the rational application of antibacterial drugs in clinical practice.

Methods.

A retrospective analysis of 94 hospitalized patients with urosepsis for 6 years was performed.

The strain composition, resistance characteristics, and the antibiogram of common bacteria from positive blood and midstream urine culture were analyzed.

Results.

A total of 87 strains were isolated, including 65 strains (74.71%) of Gram-negative bacilli, 14 strains (16.09%) of Gram-positive cocci, and 8 strains (9.20%) of fungi.

The Gram-negative bacilli included 42 strains of Escherichia coli (E.

coli) (64.62%), among which 34 strains (80.95%) were producing ESBLs, and 14 strains (21.84%) of Klebsiella pneumoniae (K.

pneumoniae), among which nine strains (64.29%) were producing ESBLs.

The most common pathogenic bacteria, ESBL+ E.

coli and K.

pneumoniae strains, showed sensitivity towards imipenem, ertapenem, piperacillin/tazobactam, amikacin, and cefotetan, but were highly resistant to quinolones.

The cure rate of urosepsis was 88.30%, and the susceptibility rate of septic shock was 45.47%.

Significance.

Gram-negative bacterial infections are the main cause of urosepsis.

The mild patient group showed more E.

coli (ESBL-) infections, and the number of ESBL producing E.

coli isolated from the mild group showed higher drug resistance rates for aztreonam and levofloxacin compared with isolates from the severe group.