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乌克兰与医疗保健相关的输卵管卵巢感染:一项多中心研究的结果(2020-2022 年)。

HEALTHCARE-ASSOCIATED TUBO-OVARIAN INFECTIONS IN UKRAINE: RESULTS OF A MULTICENTER STUDY (2020-2022).

机构信息

SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE, KYIV, UKRAINE; INSTITUTE OF PEDIATRICS, OBSTETRICS AND GYNECOLOGY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE.

SUMY STATE UNIVERSITY, SUMY, UKRAINE.

出版信息

Wiad Lek. 2022;75(8 pt 2):2003-2009. doi: 10.36740/WLek202208211.

Abstract

OBJECTIVE

The aim: To determine the current prevalence of healthcare-associated tubo-ovarian infections in female and antimicrobial resistance of the responsible pathogens in Ukraine.

PATIENTS AND METHODS

Materials and methods: We performed a retrospective multicenter cohort study was based on healthcare-associated infections surveillance data. Definitions of health¬care-associated tubo-ovarian infections were used from the CDC/ NHSN. The susceptibility to antibiotics was determined by disk diffusion method according to the EUCAST.

RESULTS

Results: Among all the 1,528 of women in this study, the prevalence of healthcare-associated tubo-ovarian infections was 31.2%. Of these cases, Salpingitis, Oophoritis, and tubo-ovarian abscess were 47.5%, 34% and 18.5%, respectively. Of all cases tubo-ovarian infections in female, 74.7% were detected after hospital discharge. The predominant pathogens were: Escherichia coli (27.7%), Enterobacter spp. (12.2%), Klebsiella pneumoniae (9.6%), Staphylococcus aureus (8.2%), Pseudomonas aeruginosa (8.1%), and Enterococcus faecalis (7.5%), followed by Proteus mirabilis (5.1%), Streptococcus spp. (4.5%), Staphylococcus epidermidis (4.4%), and Acinetibacter spp. (4%). Methicillin-resistance was ob¬served in 16.8% of S. aureus (MRSA). No strains S.aureus and E. faecalis resistant to vancomycin. The overall proportion of extended spectrum beta-lactamases (ESBL) production among Enterobacteriaceae was 24.7%. The prevalence of ESBL production among E. coli isolates was 28.6% and among K. pneumoniae 12.8%. Resistance to third-generation cephalosporins was observed in 14.9% E.coli and 11.3% K. pneumoniae isolates. Carbapenem resistance was identified in 11.3% of P.aeruginosa isolates.

CONCLUSION

Conclusions: A healthcare-associated tubo-ovarian infections of the female in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics.

摘要

目的

确定乌克兰女性医源性输卵管卵巢感染的当前流行率和相关病原体的抗菌药物耐药性。

患者和方法

我们进行了一项回顾性多中心队列研究,该研究基于医源性感染监测数据。医源性输卵管卵巢感染的定义来自疾病预防控制中心/ NHSN。抗生素敏感性通过 EUCAST 推荐的纸片扩散法确定。

结果

在这项研究的 1528 名女性中,医源性输卵管卵巢感染的患病率为 31.2%。其中,输卵管炎、卵巢炎和输卵管卵巢脓肿分别占 47.5%、34%和 18.5%。在所有女性医源性输卵管卵巢感染中,74.7%在出院后被发现。主要病原体为:大肠埃希菌(27.7%)、肠杆菌属(12.2%)、肺炎克雷伯菌(9.6%)、金黄色葡萄球菌(8.2%)、铜绿假单胞菌(8.1%)和粪肠球菌(7.5%),其次是奇异变形杆菌(5.1%)、链球菌属(4.5%)、表皮葡萄球菌(4.4%)和不动杆菌属(4%)。金黄色葡萄球菌中发现耐甲氧西林的菌株占 16.8%(MRSA)。未发现耐万古霉素的金黄色葡萄球菌和粪肠球菌。肠杆菌科中产超广谱β-内酰胺酶(ESBL)的总体比例为 24.7%。产 ESBL 的大肠埃希菌分离株占 28.6%,肺炎克雷伯菌占 12.8%。第三代头孢菌素耐药的大肠埃希菌和肺炎克雷伯菌分离株分别占 14.9%和 11.3%。11.3%的铜绿假单胞菌分离株对碳青霉烯类耐药。

结论

乌克兰女性医源性输卵管卵巢感染较为常见,许多病例由对抗生素耐药的病原体引起。

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