耐多药铜绿假单胞菌导管相关无症状细菌性尿症抗生素治疗的影响及后续感染的预测因素

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control Pub Date : 2025-01-21 DOI:10.1016/j.ajic.2025.01.015

Chisook Moon MD, PhD , Yu Mi Wi MD, PhD

{"title":"耐多药铜绿假单胞菌导管相关无症状细菌性尿症抗生素治疗的影响及后续感染的预测因素","authors":"Chisook Moon MD, PhD , Yu Mi Wi MD, PhD","doi":"10.1016/j.ajic.2025.01.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The rate of antibiotic treatment for catheter-associated asymptomatic bacteriuria (CA-ASB) remains high.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study involving hospitalized patients with multidrug-resistant <em>Pseudomonas aeruginosa</em> (MDRP) CA-ASB. Cox proportional hazards regression models were used to identify predictors for subsequent symptomatic infections in patients with MDRP CA-ASB. The probability of remaining free from symptomatic infection was analyzed using Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>The study cohort comprised 139 patients with MDRP CA-ASB. Subsequent symptomatic MDRP infections were observed in 37 (26.6%) patients. Multivariate analysis revealed that underlying urologic diseases (hazard ratio [HR]=2.17, 95% confidence interval [CI]=1.01-4.66, <em>P</em>      =.046), and recurrent bacteriuria (HR=3.57, 95% CI=1.73-7.38, <em>P</em>  =.006, log-rank test).</div></div><div><h3>Conclusions</h3><div>These findings support the current guidelines against routine antibiotic therapy, even for MDRP CA-ASB, and emphasize the need for close monitoring and timely intervention in high-risk populations.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"53 5","pages":"Pages 607-611"},"PeriodicalIF":3.8000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of antibiotic treatment and predictors for subsequent infections in multidrug-resistant Pseudomonas aeruginosa catheter-associated asymptomatic bacteriuria\",\"authors\":\"Chisook Moon MD, PhD , Yu Mi Wi MD, PhD\",\"doi\":\"10.1016/j.ajic.2025.01.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The rate of antibiotic treatment for catheter-associated asymptomatic bacteriuria (CA-ASB) remains high.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study involving hospitalized patients with multidrug-resistant <em>Pseudomonas aeruginosa</em> (MDRP) CA-ASB. Cox proportional hazards regression models were used to identify predictors for subsequent symptomatic infections in patients with MDRP CA-ASB. The probability of remaining free from symptomatic infection was analyzed using Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>The study cohort comprised 139 patients with MDRP CA-ASB. Subsequent symptomatic MDRP infections were observed in 37 (26.6%) patients. Multivariate analysis revealed that underlying urologic diseases (hazard ratio [HR]=2.17, 95% confidence interval [CI]=1.01-4.66, <em>P</em>      =.046), and recurrent bacteriuria (HR=3.57, 95% CI=1.73-7.38, <em>P</em>  =.006, log-rank test).</div></div><div><h3>Conclusions</h3><div>These findings support the current guidelines against routine antibiotic therapy, even for MDRP CA-ASB, and emphasize the need for close monitoring and timely intervention in high-risk populations.</div></div>\",\"PeriodicalId\":7621,\"journal\":{\"name\":\"American journal of infection control\",\"volume\":\"53 5\",\"pages\":\"Pages 607-611\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-01-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of infection control\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0196655325000422\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of infection control","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0196655325000422","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

摘要

背景：导管相关性无症状细菌尿（CA-ASB）的抗生素治疗率仍然很高。方法：我们对多药耐药铜绿假单胞菌（MDRP） CA-ASB住院患者进行回顾性研究。Cox比例风险回归模型用于确定MDRP CA-ASB患者后续症状感染的预测因素。用Kaplan-Meier曲线分析无症状感染的概率。结果：研究队列包括139例MDRP CA-ASB患者。37例（26.6%）患者出现后续症状性MDRP感染。多因素分析显示，泌尿系统基础疾病（HR = 2.17, 95% CI = 1.01-4.66, p = 0.047）、MDRP的积极抗生素治疗（HR = 2.34, 95% CI = 1.02-5.38, p = 0.046）和复发性菌尿（HR = 3.57, 95% CI = 1.73-7.38, p = 0.001）是随后症状性感染的独立预测因素。Kaplan-Meier分析显示，在接受MDRP CA-ASB积极抗生素治疗的患者中，无症状感染患者的累积比例显著低于未接受抗生素治疗的患者（41.7% vs. 76.4%, p = 0.006， log-rank检验）。结论：这些发现支持了目前针对MDRP CA-ASB的常规抗生素治疗指南，并强调了对高危人群进行密切监测和及时干预的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Impact of antibiotic treatment and predictors for subsequent infections in multidrug-resistant Pseudomonas aeruginosa catheter-associated asymptomatic bacteriuria

Background

The rate of antibiotic treatment for catheter-associated asymptomatic bacteriuria (CA-ASB) remains high.

Methods

We conducted a retrospective study involving hospitalized patients with multidrug-resistant Pseudomonas aeruginosa (MDRP) CA-ASB. Cox proportional hazards regression models were used to identify predictors for subsequent symptomatic infections in patients with MDRP CA-ASB. The probability of remaining free from symptomatic infection was analyzed using Kaplan-Meier curves.

Results

The study cohort comprised 139 patients with MDRP CA-ASB. Subsequent symptomatic MDRP infections were observed in 37 (26.6%) patients. Multivariate analysis revealed that underlying urologic diseases (hazard ratio [HR] = 2.17, 95% confidence interval [CI] = 1.01-4.66, P = .047), active antibiotic treatment for MDRP (HR = 2.34, 95% CI = 1.02-5.38, P = .046), and recurrent bacteriuria (HR = 3.57, 95% CI = 1.73-7.38, P = .001) were independent predictors for subsequent symptomatic infections. The Kaplan-Meier analysis demonstrated a significantly lower cumulative proportion of symptomatic infection-free patients among those receiving active antibiotic therapy for MDRP CA-ASB than among those who did not (41.7% vs 76.4%, P = .006, log-rank test).

Conclusions

These findings support the current guidelines against routine antibiotic therapy, even for MDRP CA-ASB, and emphasize the need for close monitoring and timely intervention in high-risk populations.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)