Division of Infectious Diseases, VA Ann Arbor Healthcare System, Ann Arbor, MI; Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI; Department of Veterans Affairs, University of Michigan Patient Safety Enhancement Program, Department of Veterans Affairs Hospital, Ann Arbor, MI.
Department of Veterans Affairs, University of Michigan Patient Safety Enhancement Program, Department of Veterans Affairs Hospital, Ann Arbor, MI; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI; Division of General Medicine, University of Michigan Health System, Ann Arbor, MI.
Am J Infect Control. 2018 Jul;46(7):747-750. doi: 10.1016/j.ajic.2018.01.016. Epub 2018 Mar 13.
Hospital-acquired urinary tract-related bloodstream infections are rare but often lethal. Recent epidemiology of this condition among the United States veteran population is poorly described.
We conducted a retrospective review of hospital-acquired urinary tract-related bloodstream infections of adult inpatients admitted to 4 Veterans Affairs hospitals over 15 years. Electronic medical records were used to obtain clinical, demographic, and microbiologic information. Descriptive statistical analyses were conducted using chi-square tests of association. Test for trend was performed by genus of organism and for case fatality rate over time.
While the most commonly isolated organisms were Staphylococcus spp. (36.5%), the incidence of infections caused by Escherichia and Klebsiella increased over time (P = .02 and P = .03, respectively). The overall in-hospital case fatality rate was 24.2% in 499 patients. The case fatality rate was 25.8% for patients with Staphylococcus infections and 20.7% for patients with enterococcal infections.
Hospital-acquired urinary tract-related bloodstream infection is commonly due to Staphylococcus spp. and is related to the high fatality among United States veterans. Focused infection control efforts could decrease the incidence of this fatal infection.
医院获得性尿路感染相关的血流感染虽然罕见，但往往致命。最近，美国退伍军人中这种疾病的流行病学情况描述得很差。
我们对 15 年来 4 家退伍军人事务部医院住院成人患者的医院获得性尿路感染相关血流感染进行了回顾性研究。电子病历用于获取临床、人口统计学和微生物学信息。使用卡方检验进行关联分析进行描述性统计分析。通过生物体的属和随时间推移的病死率进行趋势检验。
虽然最常分离的病原体是葡萄球菌属（36.5%），但感染大肠杆菌和克雷伯菌的发生率随着时间的推移而增加（P=0.02 和 P=0.03）。499 例患者的院内总病死率为 24.2%。葡萄球菌感染患者的病死率为 25.8%，肠球菌感染患者的病死率为 20.7%。
医院获得性尿路感染相关的血流感染通常是由葡萄球菌引起的，与美国退伍军人的高病死率有关。集中的感染控制措施可以降低这种致命感染的发生率。
