Djordjević Zorana, Ilić Milena
Srp Arh Celok Lek. 2012 Mar-Apr;140(3-4):184-90. doi: 10.2298/sarh1204184d.
Urinary tract infections are the most frequent hospital infections and account for about 40% of total hospital infections. The main risk factor for their development is the use of catheters.
Assessment of basic epidemiological and etiological characteristics of nosocomial urinary tract infections (NUTIs) and investigation of differences in risk factors among the patients with NUTIs with and without the urinary catheter.
The study comprised patients treated in chosen units/ of the Clinical Center in Kragujevac, in whom NUTI was registered during 2009. Differences in risk factors for NUTIs between the catheterized and uncatheterized patients were tested by the logistic regression analysis.
NUTIs was registered in 162 patients whose average age was 66.2 +/- 13.5 years with approximately equal gender participation (51.2% men and 48.8% women). Almost three quarters of the patients with NUITs had indwelling urinary catheter, 12.0 +/- 7.7 days on average (from 1 to 39 days). In the patients with urinary catheter, the risk for NUITs was significantly positively associated with emergency admission to hospital treatment (p=0.0185). The uncatheterized patients had a significant frequency of malignant tumours comparing to the patients with a urinary catheter (p=0.039). The compared groups did not differ in other risk factors. The most frequently isolated microbial agents was Klebsiella spp (37.3%), then Pseudomonas aeruginosa (14.1%) and Proteus mirabilis (11.9%). Most of the bacteria showed a great level of resistance to frequently used antibacterial drugs, even up to 100%.
It is necessary to define national recommendations for the prevention and control of NUTIs in the future.
尿路感染是最常见的医院感染，约占医院感染总数的40%。其发生的主要危险因素是使用导尿管。
评估医院获得性尿路感染（NUTIs）的基本流行病学和病因学特征，并调查有无导尿管的NUTIs患者危险因素的差异。
该研究纳入了克拉古耶瓦茨临床中心选定科室接受治疗的患者，这些患者在2009年期间被诊断为NUTI。通过逻辑回归分析检验导尿患者和未导尿患者NUTIs危险因素的差异。
162例患者被诊断为NUTIs，平均年龄为66.2±13.5岁，性别参与率大致相等（男性51.2%，女性48.8%）。近四分之三的NUTIs患者留置了导尿管，平均留置时间为12.0±7.7天（从1天到39天）。在导尿患者中，NUTIs的风险与紧急入院治疗显著正相关（p=0.0185）。与导尿患者相比，未导尿患者恶性肿瘤的发生率显著更高（p=0.039）。两组在其他危险因素方面无差异。最常分离出的微生物是克雷伯菌属（37.3%），其次是铜绿假单胞菌（14.1%）和奇异变形杆菌（11.9%）。大多数细菌对常用抗菌药物表现出高度耐药性，甚至高达100%。
未来有必要制定国家预防和控制NUTIs的建议。
