在一家三级护理中心住院的 COVID-19 患者中，同时感染尿路致病性大肠杆菌：一项描述性横断面研究。
Co-infection of Uropathogenic Escherichia coli among COVID-19 Patients Admitted to a Tertiary Care Centre: A Descriptive Cross-sectional Study.
机构信息
Department of Medical Microbiology, Shi-Gan International College of Science and Technology, Tribhuvan University, Kathmandu, Nepal.
Department of Clinical Laboratory, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.
出版信息
JNMA J Nepal Med Assoc. 2022 Mar 11;60(247):294-298. doi: 10.31729/jnma.7376.
INTRODUCTION
Simultaneous infection of antibiotic-resistant uropathogens in patients with COVID-19 has necessitated the revision of the prescription of broad-spectrum antibiotics on the grounds of evidence-based studies and antimicrobial stewardship principles. The objective of this study was to find out the prevalence of uropathogenic Escherichia coli co-infection among hospital-admitted COVID-19 patients of a tertiary care centre.
METHODS
This descriptive cross-sectional study was conducted in urinary tract infection suspected COVID-19 patients admitted to a tertiary care hospital, from 25th June to 24th December 2021 after ethical clearance from the Institutional Review Committee with registration number 207707860. Convenience sampling was used. Serum procalcitonin levels were also measured. Data analysis was performed using the Statistical Package for the Social Sciences software version 17.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data, and mean and standard deviation for continuous data.
RESULTS
Among the 49 hospital-admitted COVID-19 patients, 3 (6.12%) (0.59-12.83 at 95% Confidence Interval) were co-infected with uropathogenic Escherichia coli. Absolute non-susceptibility of Escherichia coli to antibiotics such as ceftriaxone, cotrimoxazole, nalidixic acid, gentamicin, and ampicillin was observed. All isolates were multidrug-resistant. All co-infected patients were female and had a median age of 35 years. Mean±SD value for procalcitonin in patients with co-infection (6.13±7.88 ng/ml) was six times higher than for the patients without co-infection (0.95±1.11 ng/ml).
CONCLUSIONS
Escherichia coli co-infection in hospitalised COVID-19 patients was less frequent as compared to published literature. The serum procalcitonin value in patients with co-infection was substantially higher than that of patients without co-infection.
KEYWORDS
antimicrobial drug resistance; co-infection; COVID-19; Escherichia coli; procalcitonin.
介绍
在 COVID-19 患者中，同时感染抗生素耐药的尿路病原体使得有必要根据循证研究和抗菌药物管理原则修改广谱抗生素的处方。本研究的目的是了解三级保健中心住院 COVID-19 患者中尿源致病性大肠埃希菌共感染的发生率。
方法
本研究为描述性横断面研究，于 2021 年 6 月 25 日至 12 月 24 日，在获得机构审查委员会伦理批准后（注册号 207707860），在一家三级医院对疑似 COVID-19 的尿路感染住院患者进行。采用便利抽样法。还测量了血清降钙素原水平。使用社会科学统计软件包版本 17.0 进行数据分析。计算了 95%置信区间的点估计值，以及二项数据的频率和比例，连续数据的均值和标准差。
结果
在 49 名住院 COVID-19 患者中，有 3 名（6.12%）（95%置信区间为 0.59-12.83）共感染了尿路致病性大肠埃希菌。观察到大肠埃希菌对头孢曲松、复方新诺明、萘啶酸、庆大霉素和氨苄西林等抗生素的绝对耐药。所有分离株均为多药耐药菌。所有共感染患者均为女性，中位年龄为 35 岁。共感染患者的降钙素原均值±标准差（6.13±7.88ng/ml）是无共感染患者的 6 倍（0.95±1.11ng/ml）。
结论
与已发表文献相比，住院 COVID-19 患者中大肠埃希菌的共感染频率较低。共感染患者的血清降钙素原值明显高于无共感染患者。
关键词
抗菌药物耐药性；共感染；COVID-19；大肠埃希菌；降钙素原。
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