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对照横断面研究:评估30例清洁间歇性自我导尿孕妇的抗生素预防策略及文献综述

Control Cross-sectional Study Evaluating an Antibiotic Prevention Strategy in 30 Pregnancies Under Clean Intermittent Self-catheterization and Review of Literature.

作者信息

Michau Adélie, Dinh Aurélien, Denys Pierre, Levy Jonathan, Chartier-Kastler Emmanuel, Bernard Louis, Dommergues Marc, Nizard Jacky

机构信息

Department of Obstetrics and Gynaecology, APHP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.

Infectious Disease Department, APHP, Hôpitaux Universitaires Paris Ile de France Ouest, Garches, France.

出版信息

Urology. 2016 May;91:58-63. doi: 10.1016/j.urology.2016.02.007. Epub 2016 Feb 18.

Abstract

OBJECTIVE

To assess the efficacy and safety of a weekly oral cycling antibiotic (WOCA) strategy to prevent UTI in women.

MATERIALS AND METHODS

We performed a monocentric, comparative, retrospective, cross-sectional study on pregnant women under clean intermittent self catheterization between January 2008 and December 2014. WOCA consisted the administration of a single-dose antibiotic, alternating antibiotic A and B once every 2 weeks, according to previous urine cultures.

RESULTS

Twenty-five women carried out 30 pregnancies. Thirteen pregnancies (43.3%) were in the WOCA group (WCG) strategy and 17 were in the non-WOCA group (NWCG) (56.7%). In the 19 (63.3%) pregnancies with urinary tract infection (UTI), 5 (38.4%) were in WCG, 14 (82.3%) were not (P = .023). There were more cystitis in NWCG (76.5% vs 23.1% P = .009) but more colonization in WCG (46.2% vs 5.8% P = .025). UTIs were due to Escherichia coli, Enterobacter cloacae, and Klebsiella pneumoniae. There was a nonsignificant increase in preterm birth in NWCG (35.3% vs 7.7% P = .10), no small for gestational age neonates, and no significant difference for the mode of delivery, birthweight, and neonatal outcome.

CONCLUSION

According to our result, WOCA seems safe and effective on symptomatic UTI frequency and could be promoted to help physicians to manage specific risks in pregnancy.

摘要

目的

评估每周口服周期性抗生素(WOCA)策略预防女性尿路感染(UTI)的疗效和安全性。

材料与方法

我们对2008年1月至2014年12月期间接受清洁间歇性自我导尿的孕妇进行了一项单中心、对比、回顾性横断面研究。WOCA包括根据先前的尿培养结果,每2周交替使用抗生素A和B,单次服用一剂抗生素。

结果

25名女性共妊娠30次。13次妊娠(43.3%)采用WOCA组(WCG)策略,17次妊娠(56.7%)采用非WOCA组(NWCG)策略。在19次(63.3%)发生尿路感染(UTI)的妊娠中,5次(38.4%)在WCG组,14次(82.3%)不在WCG组(P = 0.023)。NWCG组膀胱炎更多(76.5%对23.1%,P = 0.009),但WCG组定植更多(46.2%对5.8%,P = 0.025)。UTI由大肠杆菌、阴沟肠杆菌和肺炎克雷伯菌引起。NWCG组早产有非显著性增加(35.3%对7.7%,P = 0.10),无小于胎龄儿,分娩方式、出生体重和新生儿结局无显著差异。

结论

根据我们的结果,WOCA在有症状的UTI发生率方面似乎安全有效,可推广以帮助医生管理妊娠中的特定风险。

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