Analysis of drug susceptibility and risk factors for drug resistance of Escherichia coli in elderly patients with urinary tract infection
10.3760/cma.j.issn.0254-9026.2019.12.012
- VernacularTitle: 老年人尿路感染大肠埃希菌的药敏结果及耐药危险因素分析
- Author:
Peng ZHEN
1
;
Li GU
2
;
Yali CHEN
1
;
Ming HU
1
Author Information
1. Department of Infectious Disease, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China
2. Department of Infectious and Clinical Microbiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
- Publication Type:Journal Article
- Keywords:
Urinary tract infections;
Escherichia coli infections;
Drug tolerance
- From:
Chinese Journal of Geriatrics
2019;38(12):1372-1376
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for drug resistance of urinary tract infections-causing Escherichia coli producing extended spectrum beta-Lactamases (ESBLs) in elderly people (≥65 years old), in order to provide evidence for rational use of antibiotics in clinic.
Methods:Clinical data of elderly patients diagnosed as urinary tract infections in Beijing Chao-Yang Hospital from January 2016 to December 2017 were retrospectively analyzed. According to whether ESBLs were produced by Escherichia coli isolated from urine samples, the patients were divided into the ESBLs-producing E. Coli group (ESBLs group) and the control group. Single factor analysis was performed by Chi-square test.Logistic regression analysis was used to analyze the risk factors for ESBLs-producing Escherichia coli infections in urinary tract on the basis of statistical significance.
Results:A total of 452 strains of Escherichia coli were isolated, including 253 strains (55.97%) producing ESBLs, and 199 strains (44.03%) not producing ESBLs. The ureteral calculi (OR=2.675, 95%CI: 1.129-6.341), urinary obstructive diseases (≥ 2 kinds) (OR=8.680, 95%CI: 2.508-30.040), indwelling catheters (OR=5.762, 95%CI: 2.698-12.155), antibiotic treatment more than 2 weeks for urinary tract infections within one year (OR=3.461, 95%CI: 1.766-6.784) were independent risk factors for ESBLs-producing Escherichia coli urinary tract infections. The incidence rate of Escherichia coli resistance to various antibiotics was higher in elderly patients with urinary tract infection than in non-elderly patients.
Conclusions:Escherichia coli producing ESBLs can be easily isolated from elderly patients with urinary tract obstructive diseases, indwelling catheters and repeated long-term administration of broad-spectrum antibiotics. The proportion of ESBLs Escherichia coli-caused urinary tract infections is higher in elderly patients. Thereby, carbapenems or piperacillin/tazobactam is the reasonable antibiotics. Ampicillin, piperacillin, levofloxacin and ciprofloxacin should not be the first choice for the treatment of urinary tract infections in the elderly.
