尿道狭窄患者留置耻骨上导尿管的导尿管相关性尿路感染：来自特定抗生素谱和危险因素的回顾性调查的见解

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-05-21 DOI:10.1016/j.jiph.2025.102833

Jiahao Lin , Changhao Hou , Yubo Gu , Wei Yuan , Xianjie Xiu , Zhenwei Yu , Ruihang Zhang , Guangyu Mao , Qiang Fu , Lujie Song

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引用次数: 0

摘要

目的探讨尿道狭窄患者耻骨上导尿管相关细菌尿（SPCAB）和多药耐药细菌（MDRB）的发生率及危险因素，并比较尿标本和耻骨上导尿管病原菌的耐药模式。方法对2010年1月至2023年6月行耻骨上导尿管尿道再造术的尿道狭窄患者进行回顾性分析。收集临床资料、细菌病原体和耐药模式。热图可视化电阻分布图。描述性统计总结了人口统计学和围手术期变量；采用二元logistic回归模型确定SPCAB和MDRB的独立危险因素。结果2809份尿样中培养阳性率为42.6% %。SPCAB的优势病原菌为大肠杆菌（18.8 %）和铜绿假单胞菌（11.9 %）。常见的病原菌表现出较高的抗菌素耐药率，这与耻骨上导管分离株的情况相似。SPCAB的危险因素包括耻骨上膀胱造瘘后持续时间（OR=1.712, P = 0.049）、单管留置时间（OR=2.870, P = 0.007）、无导管定植（OR=0.079, P <； 0.001）和抗生素使用（gt；7天）。对于MDRB，显著危险因素包括耻骨上膀胱造瘘后持续时间（OR=2.014, P = 0.009）、单管留置时间（OR=2.541, P = 0.019）、MDRB未定植（OR=0.079, P <； 0.001）和术后取样。结论在SPCs治疗尿道狭窄时，我们的研究结果强调了围手术期的优先策略：早期更换导尿管（≤15天间隔），根据局部耐药模式指导经导性抗菌药物治疗。SPC培养引导的干预措施可能具有降低SPCAB风险的潜在临床价值，但需要进一步验证。

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Catheter-associated urinary tract infections in urethral stricture patients indwelling suprapubic catheter: Insights from a retrospective investigation into specific antibiogram and risk factors

Objectives

This study aimed to evaluate the incidence and risk factors of suprapubic catheter-associated bacteriuria (SPCAB) and multidrug-resistant bacteria (MDRB) in patients with urethral strictures, and compare antimicrobial resistance patterns between pathogens isolated from urinary samples and suprapubic catheters.

Methods

A retrospective analysis was performed on patients with urethral strictures who had urethral reconstructive surgery with suprapubic catheters from January 2010 to June 2023. Clinical data, bacterial pathogens, and resistance patterns were collected. Heatmaps visualized resistance profiles. Descriptive statistics summarized demographics and perioperative variables; while binary logistic regression models were applied to identify independent risk factors for SPCAB and MDRB.

Results

Among 2809 urine samples, 42.6 % yielded positive cultures. The predominant pathogens in SPCAB were Escherichia coli (18.8 %) and Pseudomonas aeruginosa (11.9 %). Common pathogens exhibited high antimicrobial resistance rates, mirroring patterns observed in suprapubic catheter isolates. Risk factors for SPCAB included duration after suprapubic cystostomy (OR=1.712, P = 0.049), indwelling time of single catheter >15 days (OR=2.870, P = 0.007), absence of catheter colonization (OR=0.079, P < 0.001), and antibiotic use >7 days. For MDRB, significant risk factors comprised duration after suprapubic cystostomy (OR=2.014, P = 0.009), indwelling time of single catheter >30 days (OR=2.541, P = 0.019), absence of MDRB colonization (OR=0.079, P < 0.001), and postoperative sampling.

Conclusions

In managing urethral strictures with SPCs, our findings emphasize prioritizing perioperative strategies: early catheter replacement (≤15-day intervals), empirical antimicrobial therapy guided by local resistance patterns. SPC culture-guided interventions may hold potential clinical value for mitigating SPCAB risks, though further validation is warranted.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.