Public Health Observatory, Graduate School, Universidad CES, Medellín, Colombia.
Department of Preventive Medicine and Public Health, Universidad de Santiago de Compostela, España CIBER of Epidemiology and Public Health, CIBERESP, Madrid, Spain.
Am J Infect Control. 2019 Dec;47(12):1479-1483. doi: 10.1016/j.ajic.2019.06.005. Epub 2019 Jul 19.
Although the factors associated to bacterial resistance in patients with asymptomatic bacteriuria (ASB) have been studied in pregnant, fertile age women, patients with spinal cord injury, and those with urogynecological disorders, nothing is known about the factors associated with multidrug-resistant (MDR) bacteria in patients with ASB and planned urological procedures. This study therefore sought to identify the sociodemographic and clinical factors associated with MDR bacteria in a cohort of patients with ASB scheduled for urological procedures.
We conducted a nested case-control study on a cohort of patients with ASB and planned urological procedures at 3 Colombian medical centers. Cases were patients with MDR bacteria and controls were patients without MDR bacteria.
A total of 184 patients were included, 41.8% (n = 77) of whom presented ASB with MDR bacteria. The factors linking ASB with MDR bacteria were: advanced age (odds ratio, 1.03; 95% confidence interval, 1.01-1.06) and hospitalization within the 3-month period before surgery (odds ratio, 2.35; 95% confidence interval, 1.08-5.21).
Bacterial resistance is frequent among patients with ASB and planned urological procedures. Advanced age and prior hospitalization should be borne in mind for patients with planned urological procedures because they are factors associated with the presence of MDR bacteria.
尽管已有研究探讨过妊娠、育龄妇女、脊髓损伤和泌尿妇科疾病患者中无症状性菌尿（ASB）患者细菌耐药的相关因素，但对于拟行泌尿科手术的 ASB 患者中与多重耐药（MDR）细菌相关的因素却知之甚少。因此，本研究旨在确定拟行泌尿科手术的 ASB 患者中与 MDR 细菌相关的社会人口学和临床因素。
我们在 3 家哥伦比亚医疗机构中对拟行泌尿科手术的 ASB 患者进行了嵌套病例对照研究。病例为 MDR 细菌感染患者，对照为非 MDR 细菌感染患者。
共纳入 184 例患者，其中 41.8%（n=77）为 ASB 合并 MDR 细菌感染。与 ASB 合并 MDR 细菌感染相关的因素包括：年龄较大（优势比，1.03；95%置信区间，1.01-1.06）和手术前 3 个月内住院（优势比，2.35；95%置信区间，1.08-5.21）。
拟行泌尿科手术的 ASB 患者中细菌耐药较为常见。对于拟行泌尿科手术的患者，应注意年龄较大和术前住院这两个因素，因为它们与 MDR 细菌的存在相关。
