Michno Mikołaj, Sydor Antoni, Pelczar Anna
Przegl Lek. 2016;73(11):824-9.
Community-acquired urinary tract infections (UTI) are one of the most common types of infections. In some cases they become a cause of hospitalization and various, sometimes serious complications.
The aim of this study was to analyze community-acquired UTI in patients hospitalized in the internal nephrology ward, taking into account causative pathogens, gender, age as well as selected risk factors.
The retrospective study analyzed patients hospitalized in the ward from 1 January 2013 till 31 December 2015 (4512 people, 2452 women and 2060 men). During this period 425 patients aged 18 to 101 years (the average age 74.5) were diagnosed with community-acquired UTI. Population was divided into four age groups (I: 18-45, II: 46-65, III: 66-80, IV ≥81). The independence test χ2 with odds ratio (OR) and 95% confidence intervals (CI) were used to analyze statistically possible relationships between pathogens, age groups, gender and selected risk factors.
425 cases of community- -acquired UTI were diagnosed that accounted for 9,4% of all hospitalized patients. An increased number of diagnosed infections occurred in the subsequent age groups (I-24, II-56, III-161, IV-184). Infections were more frequent in women (63.8%) than men (36.2%). E. coli was the main etiological factor – 74.8% (84.1% in women and 58,4% in men). The contribution of other pathogens was significantly smaller: K. pneumoniae-6.6%, P. mirabilis-5.6%, E. cloacae-3.5%, E. faecalis-1.9%, St. aureus-1.6% and others-3.5%. There was no statistically significant relationship between age groups and the type of bacteria (p>0.05). It was shown that E. coli was a more common causative agent in women (p=0.0001) than in men while P. mirabilis and E. cloacae were more common in men (p=0.0084 and p=0.002 respectively). The most common risk factor in both genders was diabetes mellitus (39.3%). Additionally the presence of catheter in the bladder (p<0.0001), stasis/hydronephrosis (p=0.0067) and cancers of the genitourinary tract (p<0.0001) were significantly more common in men.
E. coli was the most common etiologic agent of community-acquired UTI. Its contribution was significantly smaller in males than in females. The incidence of UTI was the highest in young women and elderly people. Diabetes mellitus was the most common, underlying risk factor of infections. The presence of catheter in the bladder, stasis/hydronephrosis and cancers of the genitourinary tract were significantly more frequent in men with community- acquired UTI.
社区获得性尿路感染（UTI）是最常见的感染类型之一。在某些情况下，它们会导致住院以及各种有时严重的并发症。
本研究的目的是分析内科肾病病房住院患者的社区获得性UTI，同时考虑致病病原体、性别、年龄以及选定的风险因素。
这项回顾性研究分析了2013年1月1日至2015年12月31日在该病房住院的患者（共4512人，其中女性2452人，男性2060人）。在此期间，425名年龄在18至101岁（平均年龄74.5岁）的患者被诊断为社区获得性UTI。将人群分为四个年龄组（I：18 - 45岁，II：46 - 65岁，III：66 - 80岁，IV：≥81岁）。采用独立性检验χ2以及比值比（OR）和95%置信区间（CI）来分析病原体、年龄组、性别和选定风险因素之间的统计学可能关系。
共诊断出425例社区获得性UTI病例，占所有住院患者的9.4%。在随后的年龄组中诊断出的感染病例数有所增加（I组 - 24例，II组 - 56例，III组 - 161例，IV组 - 184例）。女性感染（63.8%）比男性（36.2%）更频繁。大肠杆菌是主要病因 - 占74.8%（女性为84.1%，男性为58.4%）。其他病原体的占比显著较小：肺炎克雷伯菌 - 6.6%，奇异变形杆菌 - 5.6%，阴沟肠杆菌 - 3.5%，粪肠球菌 - 1.9%，金黄色葡萄球菌 - 1.6%，其他 - 3.5%。年龄组与细菌类型之间无统计学显著关系（p>0.05）。结果显示，大肠杆菌在女性中（p = 0.0001）比在男性中更常见，而奇异变形杆菌和阴沟肠杆菌在男性中更常见（分别为p = 0.0084和p = 0.002）。两性中最常见的风险因素是糖尿病（39.3%）。此外，膀胱留置导管（p<0.0001）、尿潴留/肾积水（p = 0.0067）和泌尿生殖道癌症（p<0.0001）在男性中明显更常见。
大肠杆菌是社区获得性UTI最常见的病原体。其在男性中的占比明显低于女性。UTI发病率在年轻女性和老年人中最高。糖尿病是最常见的潜在感染风险因素。膀胱留置导管、尿潴留/肾积水和泌尿生殖道癌症在社区获得性UTI男性患者中明显更常见。
