Pseudomonas aeruginosa Isolation from Urine Culture in Hospitalised Patients: Incidence of Complicated Urinary Tract Infections and Asymptomatic Bacteriurias and Impact on Treatment of the EUCAST 2020 Update.

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES

Antibiotics-Basel Pub Date : 2024-12-11 DOI:10.3390/antibiotics13121206

Carlo Pallotto, Paolo Milani, Caterina Catalpi, Donatella Pietrella, Giuseppe Curcio, Filippo Allegrucci, Anna Gidari, Elisabetta Svizzeretto, Giovanni Genga, Andrea Tommasi, Antonella Mencacci, Daniela Francisci

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引用次数: 0

Abstract

Background. Urinary tract infections (UTIs) and asymptomatic bacteriurias (ABU) represent a large field of interest for antimicrobial stewardship programmes especially after 2020 EUCAST update in antimicrobial susceptibility testing interpretation and the possible related increase in carbapenems' prescription rate. The aim of this study was to evaluate the impact of the 2020 EUCAST update on antibiotic prescription in UTI due to Pseudomonas aeruginosa organism and their characteristics. Methods. A retrospective observational study. We enrolled all the patients with P. aeruginosa isolation from urine, admitted to our hospital from 2018 to 2021. We compared demographic, clinical, and microbiological characteristics and treatment between cases before 2020 EUCAST update (period A, 2018-2019) and after it (period B, 2020-2021). Results. A total of 643 cases was analysed, 278 in period A and 365 in period B; 65% were ABU. Carbapenems' prescription rate significantly increased in period B when considering ABU alone (21.4% vs. 41%, p = 0.016) and all the treated cases (treated ABU and UTI; 27.8% vs. 41.4%, p = 0.013); anti-Pseudomonas cephalosporins prescription significantly decreased in period B when considering ABU alone (15.7% vs. 3.6%, p = 0.021), UTI alone (20.7% vs. 5.9%, p = 0.009) and all the treated cases (18.5% vs. 5.9%, p = 0.001). Conclusions. The 2020 EUCAST update could have contributed to an increase in carbapenem prescriptions. UTI and ABU represent a large field of interest for stewardship interventions both from a diagnostic and therapeutic point of view.

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住院患者尿培养中铜绿假单胞菌的分离：并发症尿路感染和无症状细菌尿的发生率及其对EUCAST 2020更新治疗的影响

背景。尿路感染（uti）和无症状细菌（ABU）是抗菌药物管理规划的一个重要领域，特别是在2020年EUCAST更新抗菌药物敏感性测试解释和碳青霉烯类药物处方率可能相关的增加之后。本研究的目的是评估2020年EUCAST更新对铜绿假单胞菌细菌引起的尿路感染抗生素处方的影响及其特征。方法。回顾性观察性研究。我们纳入了2018年至2021年在我院住院的所有从尿液中分离出铜绿假单胞菌的患者。我们比较了2020年EUCAST更新之前（A期，2018-2019）和之后（B期，2020-2021）病例的人口统计学、临床和微生物学特征和治疗。结果。共分析643例，A期278例，B期365例；65%是ABU。单独考虑ABU时，碳青霉烯类药物的处方率在B期显著增加（21.4%比41%，p = 0.016），所有治疗病例(治疗ABU和UTI；27.8% vs. 41.4%, p = 0.013)；单独考虑ABU （15.7% vs. 3.6%, p = 0.021）、单独考虑UTI （20.7% vs. 5.9%, p = 0.009）和所有治疗病例（18.5% vs. 5.9%, p = 0.001）， B期抗假单胞菌头孢菌素处方显著减少。结论。2020年EUCAST的更新可能导致碳青霉烯类处方的增加。从诊断和治疗的角度来看，UTI和ABU代表了管理干预的一个大领域。

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来源期刊

Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics

CiteScore

7.30

自引率

14.60%

发文量

1547

审稿时长

11 weeks

期刊介绍： Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.