Abstract:

Objective To investigate the drug resistance of Escherichia coli and Enterococcus faecalis in urinary tract infection in Pudong New District in Shanghai from 2004 to 2010, and provide evidence for clinical drug use. Methods Pathogens in urinary tract infection were collected from inpatients in community hospitals and inpatients and outpatients in Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine in Pudong New District in Shanghai from October 2004 to September 2010. Drug resistance was examined by Kirby-Bauer (K-B) method, and was analysed with WHONET 5.3 software and SPSS 13.0 software. Results A total of 4 415 strains were collected from urine of patients with urinary tract infection, among which there were 1 968 (45.6%) Escherichia coli strains and 736 (16.7%) Enterococcus faecalis strains. The drug resistance rate of strains from inpatients in community hospitals was higher than that in inpatients in Renji Hospital, and that in outpatients in Renji Hospital was the lowest. The drug resistance rates of Escherichia coli to Ampicillin and Ciprofloxacin decreased year by year. The drug resistance rates of Escherichia coli to Cefotaxime and Ceftazidime and the detection rate of extended-spectrum β-lactamases (ESBLs) strains decreased year by year. The drug resistance rates of  Escherichia coli to Gentamicin, Ampicillin/Sulbactam, Piperacillin, Cefoperazone/Sulbactam, Piperacillin/Tazobactam and Cefepime displayed a turning up at first and a turning down later. The drug resistance rate of Enterococcus faecalis to Levofloxacin increased year by year, and that to Nitrofurantoin increased before a collapse. Conclusion Escherichia coli and Enterococcus faecalis are the most common pathogens in urinary tract infection. Different clinical use of drugs may lead to different degree of drug resistance. A reasonable and effective antimicrobial therapy can improve the drug resistance.

Key words: urinary tract infection, pathogen, drug resistance, Escherichia coli, Enterococcus faecalis