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Background   Urosepsis and septic shock are a critical situation leading to a mortality rate up to 30% in patients with obstructive diseases of the urinary tract.Aim   To analyze the bacterial distribution and drug resistance of pathogenic bacteria in patients with urosepsis and to provide a basis for the rational application of antibacterial drugs in clinical practice.Methods   A retrospective analysis of 94 hospitalized patients with urosepsis for 6 years was performed. The strain composition, resistance characteristics, and the antibiogram of common bacteria from positive blood and midstream urine culture were analyzed.Results   A total of 87 strains were isolated, including 65 strains (74.71%) of Gram-negative bacilli, 14 strains (16.09%) of Gram-positive cocci, and 8 strains (9.20%) of fungi. The Gram-negative bacilli included 42 strains of  Escherichia coli  ( E. coli ) (64.62%), among which 34 strains (80.95%) were producing ESBLs, and 14 strains (21.84%) of  Klebsiella pneumoniae  ( K. pneumoniae ), among which nine strains (64.29%) were producing ESBLs. The most common pathogenic bacteria, ESBL+  E. coli  and  K. pneumoniae  strains, showed sensitivity towards imipenem, ertapenem, piperacillin/tazobactam, amikacin, and cefotetan, but were highly resistant to quinolones. The cure rate of urosepsis was 88.30%, and the susceptibility rate of septic shock was 45.47%.Significance   Gram-negative bacterial infections are the main cause of urosepsis. The mild patient group showed more  E. coli  (ESBL-) infections, and the number of ESBL producing  E. coli  isolated from the mild group showed higher drug resistance rates for aztreonam and levofloxacin compared with isolates from the severe group.

Clinical Situations of Bacteriology and Prognosis in Patients with Urosepsis