从巴西一个中等城市的大学医院收治的尿路感染患者中分离出的病原体的流行率和抗菌药耐药性概况。

IF 1.5 4区 医学 Q4 INFECTIOUS DISEASES Revista Do Instituto De Medicina Tropical De Sao Paulo Pub Date : 2024-01-05 eCollection Date: 2024-01-01 DOI:10.1590/S1678-9946202466003
Mariana Negri, Bárbara Martins Lima, Renata Dos Santos Batista Reis Woloszynek, Roberto Augusto Silva Molina, Carla Maria Ramos Germano, Débora Gusmão Melo, Leandro Cândido de Souza, Lucimar Retto da Silva de Avó
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引用次数: 0

摘要

本研究旨在确定从圣卡洛斯联邦大学大学医院收治的社区尿路感染(UTI)患者尿液样本中分离出的微生物的抗生素谱,以支持适当的本地经验性治疗。2018 年 10 月至 2020 年 10 月期间进行了一项回顾性横断面研究。表列了1528份细菌病原体尿培养阳性的数据和抗生素图谱。按性别和年龄对细菌种类的流行率及其耐药性情况进行了分析和比较。对于革兰氏阴性发酵菌,比较了曾住院治疗的患者的耐药率和该组患者的感染总数。比较采用卡方检验,必要时使用费雪精确检验(BioEstat 程序,采用 p≤ 0.05)。多变量分析用于评估研究变量对预测多重耐药性的影响。女性和老年人的感染率更高。革兰氏阴性菌占细菌培养总数的 90.44%。在男女两性中,成年人的大肠杆菌感染率明显高于老年人(p < 0.0001)。与其他年龄段的人相比,老年人对几种抗生素的耐药率较高;与这类细菌感染的总人数相比,革兰氏阴性发酵菌感染和曾住院治疗的患者的耐药率较高。住院时间越近,耐药率越高的抗生素数量越多。氨基糖苷类、碳青霉烯类、头孢他啶、硝基呋喃妥因、哌拉西林+他唑巴坦和磷霉素的耐药率低于 20%,足以用于经验性治疗。在预测耐多药细菌感染方面,只有前90天的住院情况具有统计学意义。
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Prevalence and antimicrobial resistance profile of pathogens isolated from patients with urine tract infections admitted to a university hospital in a medium-sized Brazilian city.

This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher's exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gram-negative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria.

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来源期刊
CiteScore
3.60
自引率
5.30%
发文量
100
审稿时长
6-12 weeks
期刊介绍: The Revista do Instituto de Medicina Tropical de São Paulo (Journal of the São Paulo Institute of Tropical Medicine) is a journal devoted to research on different aspects of tropical infectious diseases. The journal welcomes original work on all infectious diseases, provided that data and results are directly linked to human health. The journal publishes, besides original articles, review articles, case reports, brief communications, and letters to the editor. The journal publishes manuscripts only in English. From 2016 on, the Revista do Instituto de Medicina Tropical de São Paulo (Journal of the São Paulo Institute of Tropical Medicine) is published online only, maintaining the free access. For more information visit: - http://www.scielo.br/rimtsp - http://www.imt.usp.br/revista-imt/
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