To analyze the distribution of pathogenic bacteria and changes in antibiotic resistance among Urology patients in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University to provide a theoretical basis for guiding rational clinical drug use.

WHONET 5.6 software analyzed non-duplicate bacterial isolates and antimicrobial susceptibility data from Urology patients from 2014 to 2024.

From 2014 to 2024, pathogens were detected in 2035 Urology patients, with 51.84% male and 48.16% female. Pathogen detection rates varied slightly among age groups. The primary source of pathogen specimens was urine samples (90.37%), followed by drainage fluid (2.53%), sputum (2.46%) and blood (1.17%). A total of 2,566 non-duplicate isolates were isolated from urology patients. The detection rate of gram-negative bacilli exhibited a downward trend, with the top five detected bacteria being Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Acinetobacter baumannii. Conversely, the detection rate of gram-positive bacteria increased, with the top five being Enterococcus faecalis, Streptococcus agalactiae, Staphylococcus haemolyticus, Enterococcus faecium, and Streptococcus mitis/streptococcus oralis. Similarly, the detection rate of fungi also increased, with the top three being Candida albicans, Candida glabrata, and Candida tropicalis. No Escherichia coli resistant to tigecycline was detected. The resistance rates of Escherichia coli to imipenem, meropenem, cefoperazone/sulbactam, nitrofurantoin, ertapenem, amikacin, piperacillin/tazobactam, and cefoxitin were low (<10%). The resistance rates of Klebsiella pneumoniae to tigecycline, amikacin, imipenem, meropenem, and ertapenem were also low (<10%). For Proteus mirabilis, the resistance rates to meropenem, ertapenem, piperacillin/tazobactam, cefoperazone/sulbactam, cefoxitin, amikacin, ceftazidime, and amoxicillin/clavulanate were low (<10%). Regarding Pseudomonas aeruginosa, the resistance rates to amikacin, meropenem, imipenem, piperacillin/tazobactam, cefepime, ceftazidime, gentamicin, and tobramycin were low (<10%). Enterococcus faecalis exhibits low resistance rates (<5%) to vancomycin, nitrofurantoin, ampicillin, penicillin, and linezolid. No Streptococcus agalactiae isolates have shown resistance to vancomycin, linezolid, ampicillin, ceftriaxone, or cefotaxime. No vancomycin-, linezolid-, or nitrofurantoin-resistant Staphylococcus haemolyticus isolates were identified. Enterococcus faecium exhibited low resistance rates to linezolid and vancomycin (1.4% and 4.3%, respectively). No linezolid- or vancomycin-resistant Streptococcus mitis/oralis group strains were detected, with chloramphenicol resistance observed in only 3.5% of isolates.

In the urology department, the patient population was predominantly male, with urine specimens constituting the majority of samples. Gram-negative bacteria remained the primary pathogens, however, increasing detection rates of gram-positive bacteria and fungi warrant heightened clinical vigilance. Escherichia coli was the most prevalent isolate, demonstrating stable or declining resistance rates to most antimicrobial agents. Notably, the top five gram-negative bacilli exhibited low resistance to carbapenems, while the leading five gram-positive species showed minimal resistance to vancomycin and linezolid. These findings suggest that standardized antimicrobial stewardship practices have effectively mitigated the escalation of bacterial drug resistance.