Department of Medical Microbiology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice, Poland.
Department of Pathophysiology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, Katowice, Poland.
Med Sci Monit. 2022 Mar 25;28:e935478. doi: 10.12659/MSM.935478.
BACKGROUND Recent studies have shown that up to 25% of sepsis cases originate in the urinary tract. Urosepsis can be associated with cystitis, lower urinary tract infections (UTIs), and upper UTIs and is most commonly caused by gram-negative bacteria. This retrospective study from a urology center in southern Poland, was conducted between 2017 and 2020 and aimed to investigate the causes, microbiology laboratory findings, and management in 138 patients with UTIs and urosepsis. MATERIAL AND METHODS Records of patients with UTIs with urosepsis admitted to the Urology Department of the hospital in Silesia, Poland, between 2017 and 2020 were analyzed retrospectively, and clinical and laboratory data were evaluated. RESULTS The 138 included patients were admitted to the hospital between 2017 and 2020. The median age of patients was 67 (20-94) years, and 59.9% (82/137) were men. The most common reasons for admission to the Urology Department were hydronephrosis due to dysfunction of urinary drainage in 36.5% (50/137) of patients and hydronephrosis due to urolithiasis in 22.6% (31/137) of patients. The main etiological agents responsible for the development of urosepsis were strains of Enterobacteriaceae in 85% of patients, of which 41.4% (48/116) produced extended-spectrum beta-lactamases (ESBL), accounting for 35.0% (48/137) of patients with urosepsis. In 83.3% (80/96) of patients, the pathogen cultured from the urine was identical to that cultured from the blood. CONCLUSIONS The identification of an increasing prevalence of urosepsis associated with ESBL-producing gram-negative rods from this single-center study highlights the importance of infection monitoring, rapid diagnosis, and multidisciplinary patient management.
最近的研究表明，多达 25%的败血症病例源自尿路。尿脓毒症可与膀胱炎、下尿路感染（UTI）和上尿路感染相关，最常见的病原体是革兰氏阴性菌。这项来自波兰南部泌尿科中心的回顾性研究于 2017 年至 2020 年进行，旨在调查 138 例 UTI 和尿脓毒症患者的病因、微生物学实验室发现和治疗方法。
回顾性分析了 2017 年至 2020 年期间因 UTI 伴尿脓毒症入住波兰西里西亚医院泌尿科的患者的记录，并评估了临床和实验室数据。
138 例患者纳入研究，年龄中位数为 67（20-94）岁，59.9%（82/137）为男性。入住泌尿科的最常见原因是 36.5%（50/137）的患者因排尿功能障碍导致的肾积水和 22.6%（31/137）的患者因尿路结石导致的肾积水。导致尿脓毒症发展的主要病原体是肠杆菌科细菌，占 85%（116/137）的患者，其中 41.4%（48/116）产生超广谱β-内酰胺酶（ESBL），占尿脓毒症患者的 35.0%（48/137）。在 83.3%（80/96）的患者中，从尿液中培养出的病原体与从血液中培养出的病原体相同。
本单中心研究发现，与 ESBL 阳性革兰氏阴性菌相关的尿脓毒症患病率不断增加，这突显了感染监测、快速诊断和多学科患者管理的重要性。
