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大格拉斯哥和克莱德地区 种的流行病学和泌尿生殖道致病潜能(血液培养和尿液样本中 的描述性研究:临床意义和尿路病理的潜在标志物)。

Epidemiology and urological pathogenic potential of species in greater Glasgow and Clyde (Descriptive study of in blood culture and urinary samples: clinical importance and potential marker of urinary tract pathology).

机构信息

NHS Greater Glasgow and Clyde, Department of Medical Microbiology, Glasgow Royal Infirmary, 8-16 Alexandra Parade, Glasgow G31 2ER, UK.

Present address: NHS Greater Glasgow and Clyde, Department of Medical Microbiology, Queen Elizabeth University Hospital1345, Govan Road, Glasgow G51 4TF, UK.

出版信息

J Med Microbiol. 2023 Jun;72(6). doi: 10.1099/jmm.0.001690.

Abstract

species in particular are increasingly reported as causative agents of bacteraemia, urinary tract infection, sepsis, and endocarditis. We sought to establish the epidemiology of in Glasgow hospitals and whether the presence of the organism in clinical isolates could be an indicator of undiagnosed urinary tract pathology. The knowledge gap among clinical staffs on species as emerging pathogens can be filled by understanding its epidemiology and clinical importance. Describe the epidemiology and clinical importance of . We reviewed positive blood cultures with species (2017-2021) and urinary isolates (2021) in Glasgow hospitals. Data were collected from clinical and laboratory database systems. All 22 positive blood cultures were and sensitive to amoxicillin, vancomycin, and ciprofloxacin. The median age was 80.5; the majority was male (18). In total, 15/22 (68 %) were diagnosed with urinary tract infection. Thirteen were treated with amoxicillin. No cases of infective endocarditis were noted. One patient was subsequently diagnosed with bladder carcinoma. All 83 positive urinary isolates in 72 patients were . One was resistant to amoxicillin; two to ciprofloxacin; all sensitive to nitrofurantoin and vancomycin. The majority was female (43/83), the median age was 80. The commonest risk factors were underlying malignancy including bladder cancer (5/18), chronic kidney disease (17) and diabetes (16). Clinical data was unavailable in 24 episodes. Of these, 41/59 (69.5 %) were diagnosed with urinary tract infection. One patient was subsequently diagnosed with metastatic renal cancer while bladder wall lesions were identified in three patients, two of whom were waiting for an urology review at the time of study. Thirteen patients (18 %) had 1 year recurrent bacteriuria and three were not treated on initial episode. are emerging pathogens and are likely to become more common due to advances in laboratory technologies and an ageing population. Clinical teams should be aware of their urological pathogenic potential and not dismiss them as contaminants. Whether infection is a potential indicator for undiagnosed urinary tract malignancy warrants further studies.

摘要

物种越来越多地被报道为菌血症、尿路感染、败血症和心内膜炎的病原体。我们试图确定在格拉斯哥医院的流行病学情况,以及该生物体在临床分离株中的存在是否可以作为未诊断的尿路感染病理的指标。临床工作人员对新兴病原体物种的了解不足,可以通过了解其流行病学和临床重要性来填补这一知识空白。描述物种的流行病学和临床重要性。我们回顾了格拉斯哥医院 2017-2021 年有物种阳性的血培养和 2021 年的尿分离株。数据从临床和实验室数据库系统中收集。所有 22 例阳性血培养均为 ,对阿莫西林、万古霉素和环丙沙星敏感。中位年龄为 80.5;大多数为男性(18 例)。共有 15/22(68%)诊断为尿路感染。13 例用阿莫西林治疗。未发现感染性心内膜炎病例。一名患者随后被诊断为膀胱癌。72 例患者中 83 例阳性尿分离株均为 。1 株对阿莫西林耐药;2 株对环丙沙星耐药;对呋喃妥因和万古霉素均敏感。大多数为女性(43/83),中位年龄为 80 岁。最常见的危险因素是潜在恶性肿瘤,包括膀胱癌(5/18)、慢性肾脏病(17)和糖尿病(16)。24 例临床数据不可用。其中,41/59(69.5%)诊断为尿路感染。一名患者随后被诊断为转移性肾细胞癌,而三名患者的膀胱壁病变,其中两名在研究时正在等待泌尿科复查。13 名患者(18%)在一年内有复发性菌尿,3 名患者在初次发作时未接受治疗。是新兴的病原体,由于实验室技术的进步和人口老龄化,它们可能会变得更加常见。临床团队应该意识到它们在泌尿系统中的致病潜力,不要将其视为污染物。感染是否是未确诊的尿路感染恶性肿瘤的潜在指标还需要进一步研究。

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