Hamdan Ahmad, AbuHaweeleh Mohannad N, Al-Qassem Leena, Kashkoul Amira, Alremawi Izzaldin, Hussain Umna, Khan Sara, ElBadway Menatalla M S, Chivese Tawanda, Farooqui Habib H, Zughaier Susu M
College of Medicine, QU Health, Qatar University, Doha 2713, Qatar.
Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha 2713, Qatar.
Antibiotics (Basel). 2024 Dec 14;13(12):1218. doi: 10.3390/antibiotics13121218.
: Diabetes is linked to a higher risk of urinary tract infections (UTIs) in women, often leading to recurrent antibiotic treatments. Frequent antibiotic use for UTIs can contribute to antimicrobial resistance (AMR), a critical public health threat that increases treatment failure. This study investigated the prevalence of AMR and its associated factors among women with UTIs, comparing those with and without diabetes. : The study population had a mean age of 52 years (SD = 23) for the women without diabetes and 68 years (SD = 14) for those with diabetes. Resistance was highest for cefazolin and levofloxacin in the Access and Watch antibiotic groups, while ciprofloxacin was the most frequently prescribed antibiotic. AMR prevalence was 35.7% among the women with diabetes and 21.3% among those without. After adjustment, AMR was significantly associated with both uncomplicated diabetes (OR 1.14, 95% CI 1.08-1.21) and complicated diabetes (OR 1.54, 95% CI 1.45-1.64), as well as with higher numbers of prescribed antibiotics (OR 277.39, 95% CI 253.79-303.17). : Using a cross-sectional cohort from the Physionet database, we analyzed data on 116,902 female participants treated for UTIs, including their antibiotic exposure, diabetes status, comorbidities, and hospital admission details. Antimicrobials were classified per the WHO's AWaRe criteria. The primary outcome was AMR identified in urine cultures, and the association with diabetes status was evaluated using multivariable logistic regression. : Our findings highlight the need for focused antimicrobial stewardship in women with diabetes to reduce the AMR rates in this vulnerable group.
糖尿病与女性尿路感染（UTIs）风险较高相关，常导致反复进行抗生素治疗。因尿路感染频繁使用抗生素会导致抗菌药物耐药性（AMR），这是一个严重的公共卫生威胁，会增加治疗失败的几率。本研究调查了尿路感染女性中AMR的患病率及其相关因素，比较了患有和未患有糖尿病的女性。
研究人群中，未患糖尿病的女性平均年龄为52岁（标准差=23），患糖尿病的女性平均年龄为68岁（标准差=14）。在“准入和观察”抗生素组中，头孢唑林和左氧氟沙星的耐药率最高，而环丙沙星是最常开具的抗生素。糖尿病女性中的AMR患病率为35.7%，非糖尿病女性中的患病率为21.3%。调整后，AMR与单纯性糖尿病（比值比1.14，95%置信区间1.08 - 1.21）和复杂性糖尿病（比值比1.54，95%置信区间1.45 - 1.64）均显著相关，也与开具的抗生素数量较多相关（比值比277.39，95%置信区间253.79 - 303.17）。
我们使用Physionet数据库中的横断面队列，分析了116,902名接受尿路感染治疗的女性参与者的数据，包括她们的抗生素暴露情况、糖尿病状态、合并症和住院详情。抗菌药物根据世界卫生组织的AWaRe标准进行分类。主要结果是在尿培养中确定的AMR，并使用多变量逻辑回归评估其与糖尿病状态的关联。
我们的研究结果强调，需要对糖尿病女性进行有针对性的抗菌药物管理，以降低这一弱势群体中的AMR发生率。
