Krieger J N, Kaiser D L, Wenzel R P
J Infect Dis. 1983 Jul;148(1):57-62. doi: 10.1093/infdis/148.1.57.
During a 23-month study, we identified 1,233 patients with nosocomial urinary tract infections (UTIs) among 40,718 consecutive admissions by using a standardized, prospective system of hospital-wide surveillance. Nosocomial bloodstream infections (BSIs) occurred in 565 patients, 32 of whom had BSIs originating from UTIs, for an attack rate of 2.7 per 100 patients with nosocomial bacteriuria. Patients with UTIs due to Serratia marcescens were most likely to develop secondary BSIs (rate, 16 per 100) compared to patients with nosocomial UTIs due to other organisms (rate, less than or equal to 4.3 per 100; P less than 0.05). Furthermore, the median interval between documentation of UTI and of secondary BSI was 24 days for patients with infections due to S marcescens compared to one day for the entire group (P less than 0.005). Risk factor analysis indicated that men with UTIs were more likely to develop secondary BSIs than were women (P less than 0.05). Intensified infection control efforts are particularly necessary with high-risk groups such as bacteriuric men--especially among those patients with UTIs due to S marcescens--to reduce the incidence of secondary, hospital-acquired BSIs.
在一项为期23个月的研究中，我们通过使用标准化的全院前瞻性监测系统，在40718例连续入院患者中识别出1233例医院获得性尿路感染（UTI）患者。565例患者发生了医院获得性血流感染（BSI），其中32例BSI源于UTI，每100例医院获得性菌尿患者的发病率为2.7。与其他病原体导致的医院获得性UTI患者相比，粘质沙雷菌导致UTI的患者最易发生继发性BSI（发病率为每100例中有16例）（其他病原体导致的医院获得性UTI患者发病率≤每100例中有4.3例；P<0.05）。此外，粘质沙雷菌感染患者记录UTI与继发性BSI之间的中位间隔时间为24天，而整个研究组为1天（P<0.005）。危险因素分析表明，UTI男性患者比女性患者更易发生继发性BSI（P<0.05）。对于菌尿男性等高危人群，尤其是那些由粘质沙雷菌导致UTI的患者，加强感染控制措施对于降低继发性医院获得性BSI的发生率尤为必要。
