Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.
Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea; Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea.
Int J Infect Dis. 2019 Jul;84:109-115. doi: 10.1016/j.ijid.2019.05.002. Epub 2019 May 8.
Urinary tract infection (UTI) is a common medical complication experienced by patients with neurologic diseases. In this study, we established the microbial etiologies of UTI, and resistances to antibiotics in UTI as well as determining which appropriate empirical antibiotics should be used to treat UTI in neurological patients.
We retrospectively reviewed microbial etiologies and antimicrobial resistance among patients experiencing UTI events in the neurology ward of Seoul National University Hospital from 2007 to 2016.
The total number of UTI events observed was 301, and Klebsiella pneumoniae was the most common pathogen observed in UTIs. But in catheter-associated UTI (CAUTI), Enterococcus species were the most prevalent pathogens. Susceptibility to commonly-prescribed antibiotics decreased over 10 years, indicating increased antibiotic resistance in pathogens associated with UTI. ESBL-producing K. pneumoniae increased significantly, while increases of MDR K. pneumoniae, ESBL-producing E. coli, and VRE were not observed.
The worldwide trend of increasing drug-resistant pathogens should be considered, and further studies on antibiotics resistance in UTI are needed. These data will greatly assist physicians when they select antibiotics to treat UTIs in neurological patients.
尿路感染（UTI）是神经系统疾病患者常见的医疗并发症。本研究旨在确定 UTI 的微生物病因以及 UTI 对抗生素的耐药性，并确定哪些合适的经验性抗生素可用于治疗神经系统疾病患者的 UTI。
我们回顾性分析了 2007 年至 2016 年首尔国立大学医院神经内科 UTI 患者的微生物病因和抗菌药物耐药性。
共观察到 301 例 UTI 事件，其中最常见的病原体是肺炎克雷伯菌。但在导管相关性尿路感染（CAUTI）中，肠球菌属是最常见的病原体。10 年来，常用抗生素的敏感性下降，表明与 UTI 相关的病原体的抗生素耐药性增加。产 ESBL 的肺炎克雷伯菌显著增加，而多药耐药肺炎克雷伯菌、产 ESBL 的大肠埃希菌和万古霉素耐药肠球菌未见增加。
应考虑全球范围内耐药病原体增加的趋势，并需要进一步研究 UTI 的抗生素耐药性。这些数据将极大地帮助医生在为神经系统疾病患者选择治疗 UTI 的抗生素时提供依据。
