Pallotto Carlo, Milani Paolo, Catalpi Caterina, Pietrella Donatella, Curcio Giuseppe, Allegrucci Filippo, Gidari Anna, Svizzeretto Elisabetta, Genga Giovanni, Tommasi Andrea, Mencacci Antonella, Francisci Daniela
Infectious Diseases Clinic, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, Piazzale Menghini 1, 06132 Perugia, Italy.
Microbiology, Santa Maria della Misericordia Hospital, Piazzale Menghini 1, 06132 Perugia, Italy.
Antibiotics (Basel). 2024 Dec 11;13(12):1206. doi: 10.3390/antibiotics13121206.
Urinary tract infections (UTIs) and asymptomatic bacteriurias (ABU) represent a large field of interest for antimicrobial stewardship programmes especially after 2020 EUCAST update in antimicrobial susceptibility testing interpretation and the possible related increase in carbapenems' prescription rate. The aim of this study was to evaluate the impact of the 2020 EUCAST update on antibiotic prescription in UTI due to organism and their characteristics. A retrospective observational study. We enrolled all the patients with isolation from urine, admitted to our hospital from 2018 to 2021. We compared demographic, clinical, and microbiological characteristics and treatment between cases before 2020 EUCAST update (period A, 2018-2019) and after it (period B, 2020-2021). A total of 643 cases was analysed, 278 in period A and 365 in period B; 65% were ABU. Carbapenems' prescription rate significantly increased in period B when considering ABU alone (21.4% vs. 41%, = 0.016) and all the treated cases (treated ABU and UTI; 27.8% vs. 41.4%, = 0.013); anti-Pseudomonas cephalosporins prescription significantly decreased in period B when considering ABU alone (15.7% vs. 3.6%, = 0.021), UTI alone (20.7% vs. 5.9%, = 0.009) and all the treated cases (18.5% vs. 5.9%, = 0.001). The 2020 EUCAST update could have contributed to an increase in carbapenem prescriptions. UTI and ABU represent a large field of interest for stewardship interventions both from a diagnostic and therapeutic point of view.
尿路感染（UTIs）和无症状菌尿（ABU）是抗菌药物管理计划的一个重要关注领域，尤其是在2020年欧洲抗菌药物敏感性试验委员会（EUCAST）更新抗菌药物敏感性试验解读以及碳青霉烯类药物处方率可能相应增加之后。本研究的目的是评估2020年EUCAST更新对因特定微生物及其特征导致的UTI抗生素处方的影响。一项回顾性观察研究。我们纳入了2018年至2021年期间在我院住院且尿液培养有细菌分离的所有患者。我们比较了2020年EUCAST更新之前（A期，2018 - 2019年）和之后（B期，2020 - 2021年）病例的人口统计学、临床和微生物学特征以及治疗情况。共分析了643例病例，A期278例，B期365例；65%为无症状菌尿。仅考虑无症状菌尿时，B期碳青霉烯类药物的处方率显著增加（21.4%对41%，P = 0.016），在所有治疗病例（治疗的无症状菌尿和尿路感染）中也是如此（27.8%对41.4%，P = 0.013）；仅考虑无症状菌尿时，B期抗假单胞菌头孢菌素的处方率显著下降（15.7%对3.6%，P = 0.021），仅考虑尿路感染时（20.7%对5.9%，P = 0.009）以及所有治疗病例中（18.5%对5.9%，P = 0.001）。2020年EUCAST更新可能导致了碳青霉烯类药物处方的增加。从诊断和治疗角度来看，尿路感染和无症状菌尿是管理干预的一个重要关注领域。
