Comparison of urinary tract-related and catheter-related bloodstream infections in long-term and acute care wards: a retrospective cohort study1

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2025-03-27 DOI:10.1016/j.jiac.2025.102690

Kohei Kumagai , Ryo Inose , Asako Kimura , Yuichi Muraki

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引用次数: 0

Abstract

Background

The characteristics of bloodstream infections in patients admitted to long-term care wards remain unclear. This study examined differences in nosocomial-onset urinary tract-related bloodstream infections (UTRBSIs) and catheter-related bloodstream infections (CRBSIs) between patients admitted to long-term and acute care wards.

Methods

This retrospective cohort study was conducted at a mixed-care hospital with long-term and acute care wards from April 2015 to March 2024. Patient backgrounds, causative pathogens, antibiotic resistance, and treatment patterns were compared between the two groups.

Results

Among the 252 patients, 108 (42.9%) were diagnosed with UTRBSIs and 87 (34.5%) with CRBSIs. In UTRBSIs, the long-term care group had significantly longer hospitalization (721 vs. 16 days, P < 0.001), more frequent use of indwelling urinary catheters (76.7% vs. 28.6%, P < 0.001), and higher isolation rates of extended-spectrum β-lactamase-producing Enterobacterales (41.1% vs. 8.6%, P < 0.001). Piperacillin/tazobactam and meropenem were significantly more frequently used empirically in the long-term care group. In CRBSIs, the isolation rates of main causative pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) (9.5% vs. 6.7%, P = 0.707) and methicillin-resistant coagulase-negative Staphylococcus spp. (40.5% vs. 48.9%, P = 0.519), showed no significant differences between the two groups despite differences in patient backgrounds. Anti-MRSA agents were rarely used empirically in both groups (19.0% vs. 15.6%, P = 0.779).

Conclusions

Patients admitted to long-term care wards may require empirical therapy for UTRBSIs targeting drug-resistant Enterobacterales, while for CRBSIs, empirical use of anti-MRSA agents may be considered, similar to patients admitted to acute care wards.

查看原文本刊更多论文

长期和急性监护病房尿路相关和导尿管相关血流感染的比较：一项回顾性队列研究。

背景：长期护理病房住院患者血流感染的特点尚不清楚。本研究探讨了住院长期和急性监护病房患者院内发生尿路相关血流感染（UTRBSIs）和导管相关血流感染（CRBSIs）的差异。方法：回顾性队列研究于2015年4月至2024年3月在一家设有长期和急症监护病房的混合护理医院进行。比较两组患者背景、致病菌、抗生素耐药性和治疗方式。结果：252例患者中，108例（42.9%）诊断为UTRBSIs， 87例（34.5%）诊断为CRBSIs。在utrbsi中，长期护理组的住院时间明显更长（721天比16天，P < 0.001），留置导尿管的使用频率更高（76.7%比28.6%,P < 0.001），广谱β-内酰胺酶产肠杆菌的分离率更高（41.1%比8.6%,P < 0.001）。哌拉西林/他唑巴坦和美罗培南在长期护理组的使用频率明显更高。CRBSIs的主要致病菌耐甲氧西林金黄色葡萄球菌（MRSA）（9.5% vs. 6.7%, P = 0.707）和耐甲氧西林凝固酶阴性葡萄球菌（40.5% vs. 48.9%, P = 0.519）的分离率在两组患者背景不同的情况下差异无统计学意义。两组均很少使用抗mrsa药物（19.0% vs 15.6%, P = 0.779）。结论：入住长期护理病房的患者可能需要经验性治疗针对耐药肠杆菌的utrbsi，而对于crbsi，可以考虑经验性使用抗mrsa药物，类似于入住急性护理病房的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.