College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone.
BMC Res Notes. 2023 Oct 31;16(1):301. doi: 10.1186/s13104-023-06591-w.
Catheter-associated urinary tract infections (CAUTI) are common worldwide, but due to limited resources, its actual burden in low-income countries is unknown. Currently, there are gaps in knowledge about CAUTI due to lack of surveillance activities in Sierra Leone. In this prospective cohort study, we aimed to determine the incidence of CAUTI and associated antibiotic resistance in two tertiary hospitals in different regions of Sierra Leone.
The mean age of the 459 recruited patients was 48.8 years. The majority were females (236, 51.3%). Amongst the 196 (42.6%) catheterized patients, 29 (14.8%) developed CAUTI. Bacterial growth was reported in 32 (84%) patients. Escherichia coli (14, 23.7%), Klebsiella pneumoniae (10, 17.0%), and Klebsiella oxytoca (8, 13.6%) were the most common isolates. Most isolates were ESBL-producing Enterobacteriaceae (33, 56%) and WHO Priority 1 (Critical) pathogens (38, 71%). Resistance of K. pneumoniae, K. oxytoca, E. coli, and Proteus mirabilis was higher with the third-generation cephalosporins and penicillins but lower with carbapenems, piperacillin-tazobactam and amikacin. To reduce the high incidence of CAUTI and multi-drug resistance organisms, urgent action is needed to strengthen the microbiology diagnostic services and develop and implement catheter bundles that provide clear guidance for catheter insertion, care and removal.
导管相关尿路感染（CAUTI）在全球范围内较为常见，但由于资源有限，其在低收入国家的实际负担尚不清楚。目前，由于塞拉利昂缺乏监测活动，对 CAUTI 的了解存在空白。在这项前瞻性队列研究中，我们旨在确定塞拉利昂两个不同地区的两家三级医院 CAUTI 的发生率和相关抗生素耐药情况。
459 名入选患者的平均年龄为 48.8 岁，大多数为女性（236 例，51.3%）。在 196 例（42.6%）置管患者中，29 例（14.8%）发生 CAUTI。32 例（84%）患者报告有细菌生长。最常见的分离株为大肠埃希菌（14 株，23.7%）、肺炎克雷伯菌（10 株，17.0%）和产酸克雷伯菌（8 株，13.6%）。大多数分离株为产超广谱β-内酰胺酶的肠杆菌科（33 株，56%）和世界卫生组织优先（危急）病原体（38 株，71%）。肺炎克雷伯菌、产酸克雷伯菌、大肠埃希菌和奇异变形杆菌对第三代头孢菌素和青霉素的耐药性较高，但对碳青霉烯类、哌拉西林他唑巴坦和阿米卡星的耐药性较低。为降低 CAUTI 和耐多药菌的高发生率，需要采取紧急行动，加强微生物学诊断服务，并制定和实施导尿管套件，为导尿管插入、护理和拔出提供明确指导。
