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急性中风住院患者的导尿管相关尿路感染及其他感染:两种不同硅胶导尿管的前瞻性队列研究

Catheter-associated urinary tract infections and other infections in patients hospitalized for acute stroke: A prospective cohort study of two different silicone catheters.

作者信息

Stenzelius Karin, Laszlo Liselott, Madeja Magdalena, Pessah-Rasmusson Hélène, Grabe Magnus

机构信息

a Faculty of Health and Society , Malmö University , Malmö , Sweden.

b Department of Urology , Skåne University Hospital , Malmö , Sweden.

出版信息

Scand J Urol. 2016 Dec;50(6):483-488. doi: 10.1080/21681805.2016.1194459. Epub 2016 Jun 21.

Abstract

OBJECTIVE

Catheter-associated urinary tract infection (CAUTI) is the most common healthcare-associated infection. The primary aim of this study was to investigate whether the use of a silicone catheter coated with an ultrathin layer of a combination of the noble metals gold, palladium and silver (BIP™-silicone catheter) could reduce the incidence of CAUTI and antibiotic prescription compared with a standard silicone catheter in a cohort of acute neurological patients suffering primarily from stroke. At the same time, all infectious events requiring prescription of an antimicrobial agent were registered and are reported.

MATERIALS AND METHODS

The study was designed as a crossover cohort study enrolling men and women aged over 18 years, requiring emergency management for stroke including the insertion of an indwelling catheter. Data on patient characteristics, urinary tract infections (UTIs), other infectious events and all antibiotic prescriptions were recorded prospectively.

RESULTS

The patients' characteristics differed in the two centres in terms of age but not in diagnosis distribution. UTIs were recorded in 78 (24.2%) of the patients, ahead of pulmonary tract infections (n = 65; 20.2%). There was no difference in terms of CAUTI in the two catheter groups, even in subgroups with catheter treatment for 1 week or less. The patients with a diagnosed UTI required 3.5 more days of hospitalization than those without a UTI.

CONCLUSION

CAUTIs were the most frequent healthcare-associated infections, slightly ahead of pulmonary tract infections. No advantages of the coated catheter could be found in this cohort of critically ill patients.

摘要

目的

导尿管相关尿路感染(CAUTI)是最常见的医疗相关感染。本研究的主要目的是调查,在一组主要患有中风的急性神经科患者中,与标准硅胶导尿管相比,使用涂有贵金属金、钯和银组合的超薄层的硅胶导尿管(BIP™-硅胶导尿管)是否能降低CAUTI的发生率和抗生素处方率。同时,记录并报告所有需要开具抗菌药物处方的感染事件。

材料与方法

本研究设计为一项交叉队列研究,纳入年龄超过18岁、因中风需要紧急处理(包括插入留置导尿管)的男性和女性。前瞻性记录患者特征、尿路感染(UTI)、其他感染事件和所有抗生素处方的数据。

结果

两个中心患者的特征在年龄方面存在差异,但在诊断分布上没有差异。78例(24.2%)患者记录有UTI,高于肺部感染(n = 65;20.2%)。两个导尿管组在CAUTI方面没有差异,即使在导尿管治疗1周或更短时间的亚组中也是如此。确诊UTI的患者比未患UTI的患者住院时间多3.5天。

结论

CAUTI是最常见的医疗相关感染,略高于肺部感染。在这组重症患者中未发现涂层导尿管有任何优势。

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