Lara-Isla Alba, Medina-Polo José, Alonso-Isa Manuel, Benítez-Sala Raúl, Sopeña-Sutil Raquel, Justo-Quintas Juan, Gil-Moradillo Javier, González-Padilla Daniel A, García-Rojo Esther, Passas-Martínez Juan Bautista, Tejido-Sánchez Ángel
Department of Urology, Hospital Universitario 12 de Octubre and Madrid Complutense University, Madrid, Spain.
Urol Int. 2017;98(4):442-448. doi: 10.1159/000467398. Epub 2017 Mar 30.
Infections related to catheters in the upper urinary tract (CUUT) are associated with specific characteristics.
A prospective observational study was carried out from 2012 to 2015 to evaluate infections in patients with CUUT.
A total of 209 infections were included (99 with double-J, 81 with nephrostomy, and 29 with internal/external nephroureteral stents). Among nephrostomy tube carriers, the most frequently isolated microorganisms were Pseudomonas and Enterococcus. In those with an internal/external nephroureteral stent, Klebsiella was the most common, and 57.1% were extended-spectrum beta-lactamase-producing Klebsiella. In double-J carriers, Escherichia coli and Enterococcus were the most common microorganisms. Multiple-drug resistance (MDR) microorganisms were isolated in 28.6, 47.1, and 58.3% of patients with double-J, nephrostomy, and internal-external nephroureteral stents. A percutaneous CUUT (p = 0.005) and immunosuppression (p = 0.034) were risk factors for MDR microorganisms.
Non-E. coli bacteria are commonly isolated in patients with CUUT. MDR microorganisms are frequent, mainly in percutaneous approach or immunosuppression.
上尿路导管相关感染（CUUT）具有特定特征。
2012年至2015年进行了一项前瞻性观察研究，以评估CUUT患者的感染情况。
共纳入209例感染病例（99例使用双J管，81例使用肾造瘘管，29例使用内外侧输尿管支架管）。在肾造瘘管携带者中，最常分离出的微生物是铜绿假单胞菌和肠球菌。在使用内外侧输尿管支架管的患者中，肺炎克雷伯菌最为常见，且57.1%为产超广谱β-内酰胺酶的肺炎克雷伯菌。在双J管携带者中，大肠埃希菌和肠球菌是最常见的微生物。双J管、肾造瘘管和内外侧输尿管支架管患者中分别有28.6%、47.1%和58.3%分离出多重耐药（MDR）微生物。经皮CUUT（p = 0.005）和免疫抑制（p = 0.034）是MDR微生物的危险因素。
CUUT患者中常见非大肠埃希菌。MDR微生物很常见，主要见于经皮途径或免疫抑制患者。
