Oweis Ashraf O, Zeyad Heba N, Alshelleh Sameeha A, Alzoubi Karem H
Department of Internal Medicine, Nephrology Division, Jordan University of Science and Technology, Irbid, Jordan.
Department of Internal Medicine, Nephrology Division, The University of Jordan, Amman, Jordan.
J Multidiscip Healthc. 2022 Dec 5;15:2759-2766. doi: 10.2147/JMDH.S384386. eCollection 2022.
Acute kidney injury (AKI) is a well-known complication for hospitalized patients. Sepsis and various infections play a significant role in increasing the incidence of AKI. The present study evaluated the risk for Multidrug-resistant (MDR) infections and its effect on the incidence of AKI, hospitalization, need for dialysis, and mortality.
In a retrospective study design, data were collected from all adult patients with a positive multi-drug resistant culture who were admitted to King Abdullah University Hospital (KAUH). Records of 436 patients were reviewed between January 2017 - December 2018 with at least one year of follow-up.
The mean age was 57.3 years (SD± 23.1), and 58.5% were males. The most common source of positive cultures was sputum, with 50% positive cultures. The incidence of AKI was 59.2%. The most isolated microorganism was (76.8%), followed by (14.9%).On multivariate analysis, age (OR 1.1, 95% CI 1.1-1.2, P=0.001), HTN (OR 1.8, 95% CI 1.0-3.3, P=0.02), DM (OR 1.1, 95% CI 0.6-1.9, P=0.69) and the use of Foley catheter on chronic bases (OR 4.3, 95% CI 2.6-6.8, P<0.0001) were strong predictors of AKI. Among patients with AKI, 74.4% died compared to 44.4% among non-AKI patients (p<0.001).
In patients with MDR, AKI incidence, hospitalization, and mortality were high. Early detection and addressing the problem may decrease bad outcomes, and health education for reducing antibiotic abuse is needed to lower MDR.
急性肾损伤（AKI）是住院患者众所周知的并发症。脓毒症和各种感染在增加AKI发病率方面起着重要作用。本研究评估了多重耐药（MDR）感染的风险及其对AKI发病率、住院时间、透析需求和死亡率的影响。
在一项回顾性研究设计中，收集了所有入住阿卜杜拉国王大学医院（KAUH）且多重耐药培养结果呈阳性的成年患者的数据。回顾了2017年1月至2018年12月期间436例患者的记录，并进行了至少一年的随访。
平均年龄为57.3岁（标准差±23.1），男性占58.5%。培养结果呈阳性的最常见来源是痰液，占阳性培养结果的50%。AKI的发病率为59.2%。最常见的分离微生物是（此处原文缺失具体微生物名称）（76.8%），其次是（此处原文缺失具体微生物名称）（14.9%）。多因素分析显示，年龄（比值比1.1，95%置信区间1.1 - 1.2，P = 0.001）、高血压（比值比1.8，95%置信区间1.0 - 3.3，P = 0.02）、糖尿病（比值比1.1，95%置信区间0.6 - 1.9，P = 0.69）以及长期使用导尿管（比值比4.3，95%置信区间2.6 - 6.8，P < 0.0001）是AKI的强预测因素。在AKI患者中，74.4%死亡，而非AKI患者中这一比例为44.4%（p < 0.001）。
在MDR患者中，AKI的发病率、住院率和死亡率都很高。早期发现并解决该问题可能会减少不良后果，并且需要开展健康教育以减少抗生素滥用，从而降低MDR的发生率。
