Optimizing Antibiotic Treatment for Urinary Tract Infections Secondary to Escherichia coli in Elderly Diabetic Patients: Considering Age and Blood Glucose Control.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY Urologia Internationalis Pub Date : 2024-09-16 DOI:10.1159/000541435

Baozhu Yi, Xiaowei Xu, Zhendong Lin, Youhua He, Shuaibin Wang

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Abstract

Introduction: This study aimed to examine the susceptibility profile of Escherichia coli in urinary tract infections (UTIs) among elderly diabetic patients to support judicious and evidence-based antibiotic use.

Methods: From January 2021 to December 2022, urine culture results were analyzed to determine the distribution of pathogens, especially E. coli, and their drug susceptibility.

Results: E. coli infection was the most prevalent infection in elderly diabetic patients with UTIs, accounting for 32.6% of cases. Moreover, this bacterium's multiple resistance rate (38.3%) was significantly higher than other bacteria's multiple resistance rate (χ2 = 81.644, p < 0.05). Compared to older diabetic patients with optimal glucose control (HbA1c ≤7.0%), patients with poor glycemic control (HbA1c >7.0%) had lower resistance rates to lactams, and urine pH values were higher (p < 0.05).

Conclusion: The most common cause of UTIs is E. coli, with advanced age and diabetes being the main risk factors. To optimize UTI treatment safety and efficacy, antibiotics should be administered based on the patient's age and blood glucose control.

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优化老年糖尿病患者继发大肠杆菌尿路感染的抗生素治疗：考虑年龄和血糖控制。

引言为了研究老年糖尿病患者尿路感染中大肠埃希菌的药敏谱，以支持明智、循证地使用抗生素：方法：对2021年1月至2022年12月的尿培养结果进行分析，以确定病原体（尤其是大肠埃希菌）的分布及其药物敏感性：结果：大肠埃希菌感染是老年糖尿病患者尿路感染中最常见的感染，占 32.6%。此外，该细菌的多重耐药率（38.3%）明显高于其他细菌的多重耐药率（χ2=81.644，P<0.05）。与血糖控制较好（HbA1c≤7.0%）的老年糖尿病患者相比，血糖控制较差（HbA1c>7.0%）的患者对内酰胺类药物的耐药率较低，尿液 pH 值较高（P<0.05）：尿路感染（UTI）最常见的病因是大肠埃希菌，高龄和糖尿病是主要的风险因素。为优化 UTI 治疗的安全性和有效性，应根据患者的年龄和血糖控制情况使用抗生素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.