Epidemiological characteristics of clinically isolated bacteria from patients with urinary tract infection admitted to the intensive care unit

He Jin; Shi Nengxian; Zhang Shengrui; Wu Feng; Cai Shumin; Hu Hongbin; Liang Jingyi; Wei Qiang

doi:10.13406/j.cnki.cyxb.004111

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Epidemiological characteristics of clinically isolated bacteria from patients with urinary tract infection admitted to the intensive care unit

Excellence in medical insights\：pathogenesis and clinical treatment of sepsis | 更新时间：2026-06-11

- Epidemiological characteristics of clinically isolated bacteria from patients with urinary tract infection admitted to the intensive care unit
- Journal of Chongqing Medical University Vol. 51, Issue 6, Pages: 801-810(2026)
- 作者机构：
  
  1.南方医科大学南方医院重症医学科，广州 510515
  2.赣州市人民医院重症医学科，赣州 341000
  3.南方医科大学南方医院泌尿外科，广州 510515
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.004111
  CLC： R378
- Received：07 January 2026，
  
  Revised：2026-03-14，
  
  Accepted：16 March 2026，
  
  Published：28 June 2026
- 稿件说明：
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何劲，石能贤，张胜睿，等.ICU泌尿系感染临床分离菌的流行病学特点[J].重庆医科大学学报，2026，51（6）：801-810.

He Jin,Shi Nengxian,Zhang Shengrui,et al.Epidemiological characteristics of clinically isolated bacteria from patients with urinary tract infection admitted to the intensive care unit[J].Journal of Chongqing Medical University,2026,51(6):801-810.
何劲，石能贤，张胜睿，等.ICU泌尿系感染临床分离菌的流行病学特点[J].重庆医科大学学报，2026，51（6）：801-810. DOI： 10.13406/j.cnki.cyxb.004111.

He Jin,Shi Nengxian,Zhang Shengrui,et al.Epidemiological characteristics of clinically isolated bacteria from patients with urinary tract infection admitted to the intensive care unit[J].Journal of Chongqing Medical University,2026,51(6):801-810. DOI： 10.13406/j.cnki.cyxb.004111.

摘要

目的

探索重症监护病房（intensive care unit，ICU）患者泌尿系感染（urinary tract infection，UTI）病原菌的十年流行病学变迁及其耐药谱演变规律，为优化临床经验性抗感染治疗及制定精准的感染防控策略提供循证依据。

方法

回顾性收集2015年10月至2024年10月于2个综合类医院中ICU住院、经尿培养确诊为UTI的成年患者临床资料。根据时间分为前期（2015至2019年）与后期（2020至2024年）2个阶段，对2组患者的病原菌分布、构成比及主要病原菌的耐药性进行比较分析。

结果

共调查了455例泌尿系感染患者，最终纳入245例患者。ICU-UTI病原菌以革兰阴性菌为主（55.0%），其中大肠埃希菌占比最高，虽然2020至2024年大肠埃希菌比例较前5年更高，但差异无统计学意义（

=0.385）。革兰阳性菌和真菌比例有波动，屎肠球菌及白色念珠菌为主要病原体。耐药性方面，大肠埃希菌对多数β-内酰胺类抗生素的耐药率较高，但后5年较前敏感，屎肠球菌对青霉素耐药率从83.3%降至12.5%（

0.001），并于后5年首次检出耐万古霉素菌株（3例）。分层分析发现革兰阴性菌在合并泌尿系梗阻（urinary tract obstruction，UTO）的患者中不再占绝对优势。

结论

本中心泌尿系感染以革兰阴性菌为主，大肠埃希菌、屎肠球菌及念珠菌为主要病原。大肠埃希菌的耐药谱普遍恶化，ICU-UTI的病原谱与耐药性呈动态变化，应不断加强病原学监测、优化导尿管管理并规范抗菌药物使用。

Abstract

Objective

To investigate the epidemiological shifts in pathogenic bacteria and the evolution of their antibiotic resistance profiles over the past decade in patients with urinary tract infection（UTI） admitted to the intensive care unit（ICU），and to provide evidence-based support for optimizing empirical anti-infective therapy and formulating precise infection prevention and control strategies.

Methods

A retrospective analysis was performed for the clinical data of adult patients who were admitted to the ICU of two general hospitals from October 2015 to October 2024 and were diagnosed with UTI based on urine culture，and according to the time of admission，they were divided into early period group（2015-2019） and late period group（2020-2024）. The two groups were compared in terms of the distribution and constituent ratio of pathogenic bacteria and the antibiotic resistance profiles of the main pathogenic bacteria.

Results

A total of 455 patients with UTI were screened， and 245 were ultimately included in the study. Gram-negative bacteria were the predominant pathogens in ICU-UTI， accounting for 55.0% of all isolates， with Escherichia coli being the most common pathogen. Although the proportion of

Escherichia coli

was higher in 2020–2024 than in the preceding five years， the difference was not statistically significant（

=0.385）. There were fluctuations in the proportions of Gram-positive bacteria and fungi，among which

Enterococcus faecium

and

Candida albicans

were the main pathogens. As for antibiotic resistance profiles，

E. coli

was highly resistant to most β-lactam antibiotics，with a slight improvement in susceptibility in the latter five years；the resistance rate of

E. faecium

to penicillin decreased from 83.3% to 12.5%（

0.001），and vancomycin-resistant strains（3 isolates） were identified for the first time during 2020-2024. The stratified analysis showed that Gram-negative bacteria were no longer predominant in patients with urinary tract obstruction.

Conclusion

UTI in these two hospitals is mainly caused by Gram-negative bacteria，with the main

pathogens of

E. coli

，

E. faecium

，and

Candida

spp. The resistance profile of

E. coli

is aggravated，and there are dynamic changes in the pathogen spectrum and antibiotic resistance of ICU-UTI. It is recommended to enhance microbiological surveillance，optimize urinary catheter management，and standardize the use of antimicrobial agents.

关键词

Keywords

references

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