New trend in antimicrobial resistance of pathogens causing hospitalized complicated urinary tract infection

Objective To investigate the antimicrobial resistance of pathogens causing complicated urinary tract infection. Methods Distribution and resistance of pathogens in 260 culture-positive hospitalized complicated urinary tract patients from 1995 to 2001 were analyzed. Results Gram-negative bacilli accounted for 77. 3% , with 44. 2% of E. Coli. Gram-positive cocci accounted for 16. 9% , with 11. 6% of Enterococci; and fungi accounted for 5. 8%. E. Coli had the highest resistance rate of 84. 1% for ampicillin. Resistance rate of E. Coli to amoxicillin/clavulate(21. 3% ) was significantly lower than that to ampicillin alone ( P 0. 05) . Resistance rate of E Coli to amikacin was significantly lower than that to gentamycin(4. 9% vs 54. 3% , P 0. 01). Great proportion of E Coli was resistant to fluroquinolones with resistance rate ranging between 50% and 78%. The resistance rate to SMZ/TMP was as high as 62. 3%. Conclusions E Coli is still the major pathogen in complicated urinary tract infection in hospitalized patients. There is a tendency toward increased proportion of Klebsiella and other enterobacteriae. A substantial proportion of pathogens are resistant to antibiotics, some being multi-resistant strains. Antimicrobial therapy should be initiated under the guidance of anti-microbial sensitivity test if possible.