慢性肾脏病患者尿路感染的病原菌分布特征及耐药性分析

doi:10.3969/j.issn.1671-7171.2025.12.010

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (1198 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract 【Objective】 To investigate the distribution characteristics and antibiotic resistance of pathogens causing urinary tract infections (UTIs) in patients with chronic kidney disease (CKD). 【Methods】 A retrospective analysis was conducted on 1413 CKD patients. Urine culture specimens were subjected to microbial identification and antibiotic susceptibility testing. The infection characteristics and drug resistance patterns of the pathogens were analyzed. 【Results】 Among the 1413 specimens, 223 were urine culture-positive, with a positive rate of 15.78%. The positive rate in male patients was 15.37% (95/618) and the positive rate in female patients was 16.10% (128/795), with no statistically significant difference between the two groups (P>0.05). Among the Gram-negative bacteria (G^-) isolated from CKD patients, Escherichia coli was the most common (23.39%), followed by Klebsiella pneumoniae (14.92%) and Enterobacter faecalis (13.71%). The resistance rates of E. coli to ceftriaxone and levofloxacin both exceeded 80.00%, while K. pneumoniae showed the highest resistance to levofloxacin (81.08%). Both pathogens remained highly sensitive to imipenem and amikacin, with resistance rates below 10.00%. Among the main Gram-positive bacteria (G⁺), Enterococcus faecalis exhibited 100.00% resistance to ceftriaxone, and Enterococcus faecium showed 100.00% resistance to ceftazidime. These two major G⁺ isolates were fully susceptible to vancomycin and linezolid. 【Conclusion】 The pathogens causing urinary tract infections in CKD patients are diverse, with Escherichia coli being the most common. The isolated pathogens exhibit varying resistance patterns, highlighting the importance of selecting antibiotics based on pathogen-specific resistance profiles in clinical practice.

Key words： Kidney Diseases Chronic Disease Urinary Tract Infections Gram-Negative Bacteria Gram-Positive Bacteria Fungi Drug Resistance, Microbial

Received: 18 October 2024

PACS:

R692

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2025.12.010 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2025/V42/I12/2050

[1] WANG L M, XU X, ZHANG M, et al. Prevalence of chronic kidney disease in China: results from the sixth China chronic disease and risk factor surveillance[J].JAMA Intern Med,2023, 183(4): 298-310.
[2] 程桂青, 李晓, 周惠惠, 等. 尿路感染患者常见病原菌分布及耐药性分析[J].徐州医科大学学报, 2023, 43(7): 504-509.
[3] DOBREK Ł. Drug-related urinary tract infections[J].Wiad Lek,2021,74(7): 1728-1736.
[4] 朱晓艳, 易凡莉, 谢轶. 2010年-2021年四川大学华西医院透析与非透析慢性肾脏病患者临床感染及病原菌耐药特点分析[J].华西医学, 2022, 37(8):1170-1175.
[5] MOEIN M, GARN R M, SETTINERI J, et al. Urinary tract infection 1 year after kidney transplant: effect on kidney transplant outcomes[J].Exp Clin Transplant,2023, 21(7):556-561.
[6] SHIMIZU T, SUGIHARA T, KAMEI J, et al. Predictive factors and management of urinary tract infections after kidney transplantation: a retrospective cohort study[J].Clin Exp Nephrol,2021, 25(2):200-206.
[7] HSIAO C Y, LIN H L, LIN Y K, et al. Urinary tract infection in patients with chronic kidney disease[J].Turk J Med Sci,2014, 44(1): 145-149.
[8] 郑思强, 刘琳, 范神栋, 等. 尿路感染中常见病原菌及其特殊类型对抗菌药物的耐药情况[J].中华全科医学, 2023, 21 (11): 1852-1855.
[9] KUO I C, LEE J J, HWANG D Y, et al. Pyuria, urinary tract infection and renal outcome in patients with chronic kidney disease stage 3-5[J].Sci Rep,2020, 10(1): 19460.
[10] NESS D, OLSBURGH J. UTI in kidney transplant[J].World J Urol,2020, 38(1): 81-88.
[11] RODRĺGUEZ SÁNCHEZ M P, AFANADOR RUBIO D C, LUNA I M, et al.Impact of complicated urinary tract infection on renal graft function[J].Transplant Proc,2020, 52(4): 1173-1177.
[12] 杜雅丽, 胡爱玲, 衡媛, 等. 2018-2021年医院尿培养病原菌及菌株耐药性变迁[J].西北药学杂志, 2023, 38 (2): 208-211.
[13] PRADHAN B, PRADHAN S B. Prevalence of urinary tract infection and antibiotic susceptibility pattern to urinary pathogens in Kathmandu medical college and teaching hospital[J].Duwakot Birat J Health Sci,2017, 2(2):134-137.
[14] ZHOU L H, ZHAO H Z, CHEN Z Q, et al. Urinary tract aspergillosis in a patient with chronic kidney disease[J].BMJ Case Rep,2017, 2017: bcr2017221638.