导尿管相关性尿路感染患者细菌分离株的发生率、危险因素及耐药模式

IF 1.5 Q3 CRITICAL CARE MEDICINE
Tushar Jha, Mayuri Khaparde, Tejas S Parkhe, Bharat Purandare, Rutika Lavate
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引用次数: 0

摘要

导言:导尿管相关性尿路感染(CAUTIs)占院内尿路感染的80%和医院获得性感染的40%,使其成为全球最常见的卫生保健相关感染。尽管喹诺酮耐药大肠杆菌和广谱产生β-内酰胺酶的革兰氏阴性菌的增加,氟喹诺酮类药物仍然是一种常见的经验性治疗方法。了解与CAUTIs相关的抗菌素耐药性(AMR)至关重要。方法:一项前瞻性观察研究于2023年11月至2024年7月在印度马哈拉施特拉邦Deenanath Mangeshkar医院进行。该研究纳入重症监护病房(ICU)持续时间超过48小时且出现尿路感染症状的患者,包括发热、耻骨上不适、尿急或排尿困难。80例患者(平均年龄56.75±23.65岁;(53%男性)、细菌分离株、耐药模式和危险因素进行分析。结果:59例患者发生导管相关性尿路感染(73.75%);83.1 / 1000导管天)。年龄超过60岁、住院时间超过10天或伴有糖尿病(51.3%)、高血压(37.5%)或慢性肾病(10%)等合并症的患者风险更高。病原菌以大肠埃希菌和肺炎克雷伯菌最多(34.14%),革兰氏阴性杆菌占84.74%。假丝酵母种类以热带假丝酵母(34.78%)和耳假丝酵母(26%)最为显著。结论:本研究确定大肠杆菌、肺炎克雷伯菌和念珠菌是CAUTI的主要病原菌,革兰氏阴性菌具有明显的多药耐药性。常规抗菌素耐药性监测和有针对性的感染控制战略对于抗击cauti相关挑战和改善临床结果至关重要。引用本文:Jha T, Khaparde M, Parkhe TS, Purandare B, Lavate R.导尿管相关性尿路感染的发病危险因素及耐药性分析。中华检验医学杂志,2015;29(4):338-344。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence Risk Factors and Drug Resistance Patterns of Bacterial Isolates in Patients with Catheter-associated Urinary Tract Infections.

Introduction: Catheter-associated urinary tract infections (CAUTIs) account for 80% of nosocomial UTIs and 40% of hospital-acquired infections, making them the most common healthcare-associated infections globally. Despite the rise of quinolone-resistant Escherichia coli and extended-spectrum β-lactamase-producing gram-negative bacteria, fluoroquinolones remain a common empirical treatment. Understanding antimicrobial resistance (AMR) associated with CAUTIs is critical.

Methods: A prospective observational study was conducted from November 2023 to July 2024 at Deenanath Mangeshkar Hospital, Maharashtra, India. The study included catheterized patients in the intensive care unit (ICU) with a duration of over 48 hours showing UTI symptoms, including fever, suprapubic discomfort, urgency, or dysuria. Among 80 patients (mean age 56.75 ± 23.65 years; 53% male), bacterial isolates, resistance patterns, and risk factors were analyzed.

Results: Catheter-associated UTIs developed in 59 patients (73.75% prevalence; 83.1 per 1,000 catheter days). Patients aged over 60, hospitalized for more than 10 days, or with comorbidities like diabetes (51.3%), hypertension (HTN) (37.5%), or chronic kidney disease (10%) were at higher risk. Escherichia coli and Klebsiella pneumoniae were the most common pathogens (34.14%), with gram-negative bacilli constituting 84.74% of isolates. Candida species, particularly C. tropicalis (34.78%) and C. auris (26%), were also significant.

Conclusion: This study identifies E. coli, K. pneumoniae, and Candida species as major CAUTI pathogens, with substantial multidrug resistance among gram-negative bacteria. Regular AMR surveillance and targeted infection control strategies are essential to combat CAUTI-related challenges and improve clinical outcomes.

How to cite this article: Jha T, Khaparde M, Parkhe TS, Purandare B, Lavate R. Incidence Risk Factors and Drug Resistance Patterns of Bacterial Isolates in Patients with Catheter-associated Urinary Tract Infections. Indian J Crit Care Med 2025;29(4):338-344.

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来源期刊
CiteScore
3.50
自引率
10.00%
发文量
299
期刊介绍: Indian Journal of Critical Care Medicine (ISSN 0972-5229) is specialty periodical published under the auspices of Indian Society of Critical Care Medicine. Journal encourages research, education and dissemination of knowledge in the fields of critical and emergency medicine.
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