导尿管相关尿路感染患者细菌分离株的发病率、危险因素及耐药模式
Incidence Risk Factors and Drug Resistance Patterns of Bacterial Isolates in Patients with Catheter-associated Urinary Tract Infections.
作者信息
Jha Tushar, Khaparde Mayuri, Parkhe Tejas S, Purandare Bharat, Lavate Rutika
机构信息
Department of Pharmacy, Savitribai Phule Pune University, Pune, Maharashtra, India.
Department of Infectious Disease, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India.
出版信息
Indian J Crit Care Med. 2025 Apr;29(4):338-344. doi: 10.5005/jp-journals-10071-24932.
INTRODUCTION
Catheter-associated urinary tract infections (CAUTIs) account for 80% of nosocomial UTIs and 40% of hospital-acquired infections, making them the most common healthcare-associated infections globally. Despite the rise of quinolone-resistant and extended-spectrum β-lactamase-producing gram-negative bacteria, fluoroquinolones remain a common empirical treatment. Understanding antimicrobial resistance (AMR) associated with CAUTIs is critical.
METHODS
A prospective observational study was conducted from November 2023 to July 2024 at Deenanath Mangeshkar Hospital, Maharashtra, India. The study included catheterized patients in the intensive care unit (ICU) with a duration of over 48 hours showing UTI symptoms, including fever, suprapubic discomfort, urgency, or dysuria. Among 80 patients (mean age 56.75 ± 23.65 years; 53% male), bacterial isolates, resistance patterns, and risk factors were analyzed.
RESULTS
Catheter-associated UTIs developed in 59 patients (73.75% prevalence; 83.1 per 1,000 catheter days). Patients aged over 60, hospitalized for more than 10 days, or with comorbidities like diabetes (51.3%), hypertension (HTN) (37.5%), or chronic kidney disease (10%) were at higher risk. and were the most common pathogens (34.14%), with gram-negative bacilli constituting 84.74% of isolates. species, particularly (34.78%) and (26%), were also significant.
CONCLUSION
This study identifies , , and species as major CAUTI pathogens, with substantial multidrug resistance among gram-negative bacteria. Regular AMR surveillance and targeted infection control strategies are essential to combat CAUTI-related challenges and improve clinical outcomes.
HOW TO CITE THIS ARTICLE
Jha T, Khaparde M, Parkhe TS, Purandare B, Lavate R. Incidence Risk Factors and Drug Resistance Patterns of Bacterial Isolates in Patients with Catheter-associated Urinary Tract Infections. Indian J Crit Care Med 2025;29(4):338-344.
引言
导尿管相关尿路感染（CAUTIs）占医院获得性尿路感染的80%，占医院获得性感染的40%，使其成为全球最常见的医疗保健相关感染。尽管耐喹诺酮和产超广谱β-内酰胺酶的革兰氏阴性菌有所增加，但氟喹诺酮类药物仍然是一种常见的经验性治疗药物。了解与CAUTIs相关的抗菌药物耐药性（AMR）至关重要。
方法
2023年11月至2024年7月在印度马哈拉施特拉邦的迪纳纳特·曼格什卡尔医院进行了一项前瞻性观察研究。该研究纳入了重症监护病房（ICU）中留置导尿管超过48小时且出现UTI症状（包括发热、耻骨上不适、尿急或尿痛）的患者。在80名患者（平均年龄56.75±23.65岁；53%为男性）中，分析了细菌分离株、耐药模式和危险因素。
结果
59名患者发生了导尿管相关UTIs（患病率73.75%；每1000个导尿日83.1例）。60岁以上、住院超过10天或患有糖尿病（51.3%）、高血压（HTN）（37.5%）或慢性肾脏病（10%）等合并症的患者风险更高。大肠埃希菌和肺炎克雷伯菌是最常见的病原体（34.14%），革兰氏阴性杆菌占分离株的84.74%。肠球菌属物种，特别是粪肠球菌（34.78%）和屎肠球菌（26%）也很显著。
结论
本研究确定大肠埃希菌、肺炎克雷伯菌和肠球菌属物种为主要的CAUTI病原体，革兰氏阴性菌中存在大量多重耐药情况。定期进行AMR监测和针对性的感染控制策略对于应对与CAUTI相关的挑战和改善临床结局至关重要。
如何引用本文
Jha T, Khaparde M, Parkhe TS, Purandare B, Lavate R. 导尿管相关尿路感染患者细菌分离株的发病率、危险因素和耐药模式。《印度重症监护医学杂志》2025；29(4):338 - 344。
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