To isolate multi-drug resistant bacterial strains from the urinary tract of hospitalized patients with indwelling catheters at a general hospital and identify its risk factors, in order to provide a scientific basis for the prevention and control of multi-drug resistant bacteria in the urinary tract.

The data of hospitalized patients with indwelling catheters from January 2017 to December 2018 was collected at a general hospital, and the study subjects were screened according to the inclusion and exclusion criteria. The data of the bacteria and multi-drug resistant bacteria from the patients were acquired from the clinical laboratory, and the relationship between influencing factors and the isolation of multi-drug resistant bacteria was analyzed via univariate analysis. A logistic regression model was established to analyze the relationship between the isolation of multi-drug resistant bacteria from the urinary tract and the risk factors, and the relevant high-risk factors was analyzed by stratified analysis method.

The isolation rate of multi-drug resistant bacteria in all strains was 17.57% (26 strains). Among the patients with indwelling catheters ≥7 days, 22 (86.42%) strains of Gram-negative multi-drug resistant bacteria were isolated. Univariate analysis showed that gender, diabetes, admission to ICU, and application of dual and triple antibiotics were related to the isolation of multidrug-resistant bacteria from the urinary tract of patients with indwelling catheters (P＜0.05). Logistic regression analysis showed that diabetes (OR=3.48), admission to ICU (OR=3.80) and application of triple antibiotics (OR=4.32) were independent risk factors for the isolation of multi-drug resistant bacteria. Stratification analysis showed that the application of triple antibiotics was significantly related to the isolation of multi-drug resistant bacteria (P＜0.001), and with the increasing exposure days of the application of triple antibiotics, the isolation rate of multi-drug resistant bacteria increased (P_trend＜0.001).

Diabetes, admission to ICU, and application of triple antibiotics are independent risk factors for the isolation of multidrug-resistant bacteria from the urinary tract of patients with indwelling catheters. The application of triple antibiotics in patients with indwelling catheters who have been admitted to the ICU is significantly related to the isolation of multidrug-resistant bacteria from the urinary tract, and with the increasing in the exposure days of the application of triple antibiotics, the isolation rate gradually increases. Clinicians should take some preventive and control measures against the above risk factors.