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罗马尼亚蒂米什瓦拉的糖尿病患者尿路感染的特征:尿病原体的流行情况、病因和抗菌药物耐药性。

Characteristics of Urinary Tract Infections in Patients with Diabetes from Timișoara, Romania: Prevalence, Etiology, and Antimicrobial Resistance of Uropathogens.

机构信息

Department of Internal Medicine II: Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.

Department of Diabetes, Nutrition and Metabolic Diseases, "Pius Brînzeu" Emergency Clinical County Hospital, 300723 Timisoara, Romania.

出版信息

Medicina (Kaunas). 2024 Nov 14;60(11):1870. doi: 10.3390/medicina60111870.

Abstract

: Diabetic patients are more likely to develop infections compared to the general population, especially urinary tract infections (UTIs). The aim of this study was to assess the prevalence of UTIs in a population of patients with diabetes (DM) from Romania, to identify the most common uropathogens and their antimicrobial resistance (AMR) patterns, as well as to determine the correlations between resistance behavior and particularities of patients with UTIs according to DM type. : The hospital records of 1282 type 1 (T1D) and type 2 DM (T2D) adult inpatients who were ordered urine cultures during hospitalization were reviewed, and all 241 patients who presented a positive urine culture were included in the present study analysis. : The prevalence of UTIs in diabetic patients was 18.8% and higher in patients with T2D vs. T1D. Patients with UTIs and T2D had a significantly older age, longer duration of DM, higher waist circumference and body mass index, lower levels of estimated glomerular filtration rate, and more frequent chronic complications of DM than patients with T1D. was the most frequently isolated uropathogen (56.4%), with a significantly higher incidence for T2D, followed by (12.9%) and spp. (9.5%). Although the acquired resistance phenotypes were more frequently isolated in T2D patients (over 90% of the multidrug-resistant and extended-spectrum beta-lactamase-producing isolates, respectively, and 75% of the total carbapenem-resistant organisms), no statistically significant correlation was found regarding the distribution of AMR patterns in the two types of DM. : The present study brings new data regarding the prevalence of UTIs in diabetic patients from Western Romania. By identifying the spectrum of uropathogens and their AMR pattern, this paper may contribute to improving UTI management in diabetic patients, thus reducing antibiotic overuse and preventing recurrent UTIs.

摘要

糖尿病患者比一般人群更容易发生感染,尤其是尿路感染(UTI)。本研究旨在评估罗马尼亚糖尿病(DM)患者人群中 UTI 的患病率,确定最常见的尿路病原体及其抗生素耐药(AMR)模式,并确定耐药行为与 DM 类型的 UTI 患者的特殊性之间的相关性。

回顾了在住院期间进行尿液培养的 1282 例 1 型(T1D)和 2 型(T2D)成年住院糖尿病患者的病历,将所有 241 例尿液培养阳性的患者纳入本研究分析。

糖尿病患者 UTI 的患病率为 18.8%,T2D 患者高于 T1D 患者。患有 UTI 和 T2D 的患者年龄明显较大,DM 病程较长,腰围和体重指数较高,估算肾小球滤过率水平较低,DM 慢性并发症较 T1D 患者更频繁。 是最常分离的尿路病原体(56.4%),T2D 患者的发病率明显更高,其次是 (12.9%)和 spp.(9.5%)。尽管获得性耐药表型在 T2D 患者中更常分离(分别超过 90%的多药耐药和产扩展谱β-内酰胺酶的分离株,以及 75%的总碳青霉烯类耐药菌),但在两种类型的 DM 中,未发现 AMR 模式分布存在统计学显著相关性。

本研究提供了来自罗马尼亚西部糖尿病患者 UTI 患病率的新数据。通过确定尿路病原体的谱及其 AMR 模式,本文可能有助于改善糖尿病患者的 UTI 管理,从而减少抗生素的过度使用,并预防复发性 UTI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4d4/11596453/c38db0da399a/medicina-60-01870-g001.jpg

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