一家三级医院重症监护室住院病人泌尿系统病原体的多药耐药性发生率

Shaista Ahmed, Neetu Shree, Ajit Singh Narula, Purushottam Kr Nirala, Haya Majid, Aakriti Garg, Uzma Nayeem, Mohd Ashif Khan
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摘要

尿路感染(UTI)是最常见的细菌感染之一,由于抗菌药耐药性(AMR)不断增加,给公共卫生带来了巨大挑战。本研究旨在评估重症监护病房收治的印度尿路感染患者的患病率、人口统计学特征、微生物特征和抗菌药耐药性模式。这项横断面研究共纳入了 154 名尿毒症阳性患者。研究收集了包括人口统计学、微生物分离物和抗菌药敏感性模式在内的患病率数据。此外,还利用多变量分析评估了耐多药尿路病原体的风险因素。患者队列的人口结构各不相同,男性略占多数,占 52.6%(81 人)。最常见的合并症是高血压 59.1%(n = 91)和糖尿病 54.5%(n = 84)。微生物特征以革兰阴性菌为主,尤其是大肠埃希菌 26.62%(n = 41)和肺炎克雷伯菌 17.53%(n = 27)。主要的革兰氏阳性菌和真菌分离物分别是粪肠球菌 7.14%(n = 11)和念珠菌 18.83%(n = 29)。不同病原体对常用抗菌药的耐药性存在差异。革兰氏阴性菌,尤其是大肠埃希菌和肺炎克雷伯菌的耐药率很高,这凸显了抗菌药耐药性所带来的挑战。多变量逻辑回归发现,50-65 岁年龄组和 65 岁以上年龄组以及长期导管插入术是 MDR 感染的重要风险因素。病原体的耐药率明显偏高,强调了谨慎使用抗菌药物的必要性。我们的研究结果表明,有必要根据当地病原体的流行情况和抗生素图谱数据进行持续监测并采取有针对性的干预措施,以有效应对 AMR 的威胁,从而更好地管理 ICU 环境中的 UTI 管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The prevelance of multidrug resistance in uropathogens of patients admitted in the intensive care unit of a tertiary care hospital

Urinary tract infections (UTIs) are among the most common bacterial infections, posing significant public health challenges due to increasing antimicrobial resistance (AMR). This study aims to assess the prevalence, demographic characteristics, microbial profile, and antimicrobial resistance patterns in Indian patients with UTIs admitted to intensive care unit. A total of 154 patients with positive UTIs were included in this cross-sectional study. The prevalence data including demographics, microbial isolates, and antimicrobial susceptibility patterns were collected. Additionally, risk factors for multidrug resistance uropathogens were assessed using multivariate analyses. The patient cohort had diverse demographic, with a slight male predominance of 52.6% (n = 81). The most common comorbidities were hypertension 59.1% (n = 91) and diabetes mellitus 54.5% (n = 84). The microbial profile was dominated by gram-negative bacteria, particularly Escherichia coli 26.62% (n = 41) and Klebsiella pneumoniae 17.53% (n = 27). The predominant gram-positive and fungal isolate was Enterococcus faecium 7.14% (n = 11) and Candida spp. 18.83% (n = 29), respectively. Substantial resistance was noted against common antimicrobials, with variations across different pathogens. Gram-negative bacteria, particularly Escherichia coli and Klebsiella pneumoniae, exhibited high MDR rates, emphasizing the challenge of antimicrobial resistance. Multivariate logistic regression identified age groups 50–65 and over 65, and prolonged catheterization as significant risk factors for MDR infections. A significantly high resistance rate among pathogens emphasizes the need for judicious antimicrobial use. Our findings emphasize the necessity of ongoing surveillance and tailored interventions based on local pathogen prevalence and antibiogram data to effectively address the threat of AMR threat for better management of UTI management in ICU settings.

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