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孕妇多重耐药性尿路感染及其与不良妊娠结局的关联——一项回顾性研究

Multidrug-Resistant Urinary Tract Infections in Pregnant Patients and Their Association with Adverse Pregnancy Outcomes-A Retrospective Study.

作者信息

Anton Gabriel-Ioan, Gheorghe Liliana, Radu Viorel-Dragos, Scripcariu Ioana-Sadiye, Vasilache Ingrid-Andrada, Carauleanu Alexandru, Condriuc Iustina-Solomon, Socolov Razvan, Onofrei Pavel, Pruteanu Andreea-Ioana, Ursu Ramona-Gabriela, Gisca Tudor, Socolov Demetra

机构信息

Department of Mother and Child Care, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania.

Surgical Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

出版信息

J Clin Med. 2024 Nov 6;13(22):6664. doi: 10.3390/jcm13226664.

Abstract

: Multidrug-resistant urinary tract infections (MDR UTIs) constitute an important public health problem, especially in pregnant patients. The aim of this retrospective study was to characterize the bacterial spectrum and the profile of microbial resistance in cases of UTIs occurring in pregnant women, as well as their impact on obstetrical and neonatal outcomes. : A total of 371 pregnant patients with UTIs were included in the analysis and were segregated into the following groups based on the type of bacterial resistance to antibiotics: MDR UTIs (70 patients, group 1), UTIs resistant to one class of antibiotics (108 patients, group 2), UTIs resistant to two classes of antibiotics (102 patients, group 3), and sensitive UTIs (91 patients, group 4). We used descriptive statistics for characterizing and comparing the microbial spectrum and the clinical characteristics of the patients. A multinomial logistic regression model for evaluating the relationship between the type of urinary tract infection and adverse obstetric or neonatal outcomes was employed. : In the case of MDR UTIs, the bacterial spectrum mainly included , , and . We found almost universal resistance to ampicillin. Our data confirmed an increased risk of preterm birth, premature rupture of membranes, neonatal respiratory distress syndrome, and neonatal intensive care unit admission for patients with MDR infections. : The increased incidence of pathogens resistant to commonly used antibiotic classes in pregnancy suggests the need for the development of local and national protocols that adapt therapeutic and prophylactic regimens to clinical realities.

摘要

多重耐药性尿路感染(MDR UTIs)是一个重要的公共卫生问题,在孕妇中尤为如此。这项回顾性研究的目的是描述孕妇尿路感染病例的细菌谱和微生物耐药情况,以及它们对产科和新生儿结局的影响。

共有371例患有尿路感染的孕妇被纳入分析,并根据对抗生素的耐药类型分为以下几组:多重耐药性尿路感染(70例患者,第1组)、对一类抗生素耐药的尿路感染(108例患者,第2组)、对两类抗生素耐药的尿路感染(102例患者,第3组)和敏感尿路感染(91例患者,第4组)。我们使用描述性统计来描述和比较患者的微生物谱和临床特征。采用多项逻辑回归模型评估尿路感染类型与不良产科或新生儿结局之间的关系。

在多重耐药性尿路感染病例中,细菌谱主要包括 、 和 。我们发现对氨苄青霉素几乎普遍耐药。我们的数据证实,多重耐药感染患者早产、胎膜早破、新生儿呼吸窘迫综合征和新生儿入住重症监护病房的风险增加。

孕期对常用抗生素类耐药的病原体发病率增加表明,需要制定地方和国家方案,使治疗和预防方案适应临床实际情况。

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