PDF(Pubmed)
Abstract：
This study compared rates of empirical-therapy use and negative patient outcomes between complicated and recurrent urinary tract infection (r/cUTI) cases diagnosed with a multiplex polymerase chain reaction or pooled antibiotic susceptibility testing (M-PCR/P-AST) vs. standard urine culture (SUC). Subjects were 577 symptomatic adults (n = 207 males and n = 370 females) presenting to urology/urogynecology clinics between 03/30/2022 and 05/24/2023. Treatment and outcomes were recorded by the clinician and patient surveys. The M-PCR/P-AST (n = 252) and SUC (n = 146) arms were compared after patient matching for confounding factors. The chi-square and Fisher\'s exact tests were used to analyze demographics and clinical outcomes between study arms. Reduced empirical-treatment use (28.7% vs. 66.7%), lower composite negative events (34.5% vs. 46.6%, p = 0.018), and fewer individual negative outcomes of UTI-related medical provider visits and UTI-related visits for hospitalization/an urgent care center/an emergency room (p < 0.05) were observed in the M-PCR/P-AST arm compared with the SUC arm. A reduction in UTI symptom recurrence in patients ≥ 60 years old was observed in the M-PCR/P-AST arm (p < 0.05). Study results indicate that use of the M-PCR/P-AST test reduces empirical antibiotic treatment and negative patient outcomes in r/cUTI cases.
摘要：
这项研究比较了多重聚合酶链反应或混合抗生素敏感性测试（M-PCR/P-AST）诊断为复杂和复发性尿路感染（r/cUTI）的经验疗法使用率和阴性患者结局标准尿培养（SUC）。受试者是在2022年3月30日至2023年5月24日期间到泌尿科/泌尿妇科诊所就诊的577名有症状的成年人（n=207名男性和n=370名女性）。临床医生和患者调查记录治疗和结果。在患者匹配混杂因素后，比较了M-PCR/P-AST（n=252）和SUC（n=146）组。卡方和Fisher精确检验用于分析研究组之间的人口统计学和临床结果。减少经验性治疗的使用（28.7%与66.7%），较低的复合负面事件（34.5%与46.6%,p=0.018),与SUC组相比,在M-PCR/P-AST组中观察到的UTI相关医疗提供者访视和UTI相关住院/紧急护理中心/急诊室访视的个体阴性结果较少(p<0.05).在M-PCR/P-AST组中观察到≥60岁患者的UTI症状复发减少(p<0.05)。研究结果表明，使用M-PCR/P-AST测试减少了r/cUTI病例中经验性抗生素治疗和阴性患者结局。
