Perdana Muhammad A, Wahyuni Dian D, Yunita Rina
Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Department of Microbiology, Universitas Sumatera Utara, Medan, Indonesia.
Narra J. 2023 Dec;3(3):e436. doi: 10.52225/narra.v3i3.436. Epub 2023 Dec 28.
Catheter-associated urinary tract infection (CAUTI) is defined as a urinary tract infection associated with catheter placement for more than two consecutive days. Hence, antibiotic resistance in the context of CAUTIs represents a substantial challenge. The aim of this study was to present the characteristics of patients with CAUTI and the susceptibility pattern of CAUTI bacteria in the national reference hospital of the Sumatra region of Indonesia. A cross-sectional study was conducted at H. Adam Malik General Hospital, Medan, Indonesia, from 2020 to 2021, using a total sampling. All CAUTI patients included were on catheterization and diagnosed based on the Centers for Disease Control and Prevention (CDC) guidelines. The patient's urine culture and antibiotic susceptibility test were carried out on the patient's admitted urine sample for further assessment. Identification of bacteria, antibiotic susceptibility test, and the extended-spectrum beta-lactamase (ESBL) test for and were conducted using the VITEK-2 Compact. A total of 74 CAUTI patients were included in the study, 59.5% were female, 54.1% were 46-65 years old, and a third had cardiovascular disease comorbidities (33.8%). A total of 83 CAUTI-associated bacteria were isolated. The majority were Gram-negative bacteria (74.7%), and the most bacteria isolated was (31.3%), followed by , and . The ESBL test was positive mostly in (100%) and (76.9%). CAUTI-associated was susceptible to tigecycline, meropenem, ertapenem, nitrofurantoin, and gentamicin. The isolated was susceptible to tigecycline, meropenem, ertapenem, and amikacin. While showed susceptibility to tigecycline, nitrofurantoin, vancomycin, imipenem, linezolid, ampicillin, piperacillin/tazobactam, amoxicillin/clavulanic acid, ampicillin/sulbactam, and piperacillin.
导尿管相关尿路感染(CAUTI)被定义为与连续两天以上留置导尿管相关的尿路感染。因此,CAUTIs背景下的抗生素耐药性是一个重大挑战。本研究的目的是呈现印度尼西亚苏门答腊地区国家参考医院中CAUTI患者的特征以及CAUTI细菌的药敏模式。2020年至2021年在印度尼西亚棉兰的H. Adam Malik综合医院进行了一项横断面研究,采用全样本抽样。所有纳入的CAUTI患者均接受导尿,并根据疾病控制与预防中心(CDC)指南进行诊断。对患者入院时的尿液样本进行尿培养和抗生素敏感性试验,以作进一步评估。使用VITEK-2 Compact对细菌进行鉴定、抗生素敏感性试验以及超广谱β-内酰胺酶(ESBL)试验。本研究共纳入74例CAUTI患者,其中59.5%为女性,54.1%年龄在46 - 65岁之间,三分之一患有心血管疾病合并症(33.8%)。共分离出83株与CAUTI相关的细菌。大多数为革兰氏阴性菌(74.7%),分离出最多的细菌是大肠埃希菌(31.3%),其次是肺炎克雷伯菌、铜绿假单胞菌等。ESBL试验大多在大肠埃希菌(100%)和肺炎克雷伯菌(76.9%)中呈阳性。与CAUTI相关的大肠埃希菌对替加环素、美罗培南、厄他培南、呋喃妥因和庆大霉素敏感。分离出的肺炎克雷伯菌对替加环素、美罗培南、厄他培南和阿米卡星敏感。而铜绿假单胞菌对替加环素、呋喃妥因、万古霉素、亚胺培南、利奈唑胺、氨苄西林、哌拉西林/他唑巴坦、阿莫西林/克拉维酸、氨苄西林/舒巴坦和哌拉西林敏感。