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慢性肾脏病患者的尿路感染:一项临床观察性研究

Urinary Tract Infection in Chronic Kidney Disease Population: A Clinical Observational Study.

作者信息

Shankar Mythri, Narasimhappa Shashikala, N S Madhura

机构信息

Nephrology, Institute of Nephro-Urology, Bengaluru, IND.

Microbiology, Institute of Nephro-Urology, Bengaluru, IND.

出版信息

Cureus. 2021 Jan 4;13(1):e12486. doi: 10.7759/cureus.12486.

Abstract

Introduction Chronic kidney disease (CKD) is a state of chronic inflammation. Chronic inflammation weakens the body's immune response to infections. Hence, CKD patients are at an increased risk of infections. Urinary tract infection (UTI) is one of the most common types of community-acquired infection. There is a paucity of data with respect to UTI in CKD patients. Hence, our objective was to study the clinical and microbiological profile of UTI in CKD patients. Materials and methods We studied 129 CKD patients at a tertiary care hospital in south India from January 2020 to June 2020. Patients who fulfilled the inclusion criteria were included in the study. Urine samples were cultured aseptically. Only urine-culture positive samples were included in the study and antibiotic susceptibility was recorded. Results Males (76.2%) were most commonly infected. 94% were gram-negative bacteria, 3% were gram-positive bacteria and 3% were Candida species. E. coli (61.8%) was the most common isolated microorganism. Resistance to quinolones was recorded among gram-negative bacteria. Resistance to penicillin and quinolones was noted among gram-positive bacteria. Candida species were sensitive to amphotericin B and fluconazole. Conclusion The results of the study help in formulating the empiric antibiotic policy to treat UTI in CKD patients and hence prevent inadvertent use of antibiotics and the emergence of antibiotic resistance.

摘要

引言 慢性肾脏病(CKD)是一种慢性炎症状态。慢性炎症会削弱机体对感染的免疫反应。因此,CKD患者发生感染的风险增加。尿路感染(UTI)是社区获得性感染最常见的类型之一。关于CKD患者尿路感染的数据较少。因此,我们的目的是研究CKD患者尿路感染的临床和微生物学特征。

材料与方法 我们于2020年1月至2020年6月在印度南部一家三级护理医院对129例CKD患者进行了研究。符合纳入标准的患者被纳入研究。无菌采集尿液样本。仅将尿培养阳性样本纳入研究并记录抗生素敏感性。

结果 男性感染最为常见(76.2%)。94%为革兰阴性菌,3%为革兰阳性菌,3%为念珠菌属。大肠埃希菌(61.8%)是最常见的分离微生物。革兰阴性菌对喹诺酮类耐药。革兰阳性菌对青霉素和喹诺酮类耐药。念珠菌属对两性霉素B和氟康唑敏感。

结论 本研究结果有助于制定治疗CKD患者尿路感染的经验性抗生素策略,从而避免抗生素的不当使用和抗生素耐药性的出现。

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