uropathogens

尿路病原体
  • 文章类型: Journal Article
    尿路感染对个人的生活质量产生重大负面影响,并造成重大的经济和公共卫生负担。因此,本研究旨在确定WadMedani患者与尿路感染相关的常见细菌性尿路病原体及其对抗生素的敏感性.
    这是一项横断面研究。所有尿液样本均来自WadMedani的患者,并在病理诊断和研究中心进行了调查。医学院,Gezira大学,苏丹,从2021年1月1日至2023年10月15日。
    在三年的研究期间共分析了2698个尿液样本,平均年龄45.29±18.9岁。在这些患者中,1108(41.8%)细菌生长呈阳性,其中888人(80.14%)为女性。革兰阳性菌(GPB)共522例(47.1%),革兰阴性菌(GNB)586例(52.9%)。最常见的细菌是金黄色葡萄球菌42%(465/1108)和大肠杆菌38.5%(427/1108),铜绿假单胞菌检出率较低3.4%(38/1108)。阿米卡星91.5%是对分离的GPB最敏感的药物,而复方新诺明20.9%是最不敏感的药物。特别是,阿米卡星94.1%(144/153)是金黄色葡萄球菌最敏感的药物,而复方新诺明20.7%(80/386)是最不敏感的药物。此外,阿米卡星91.5%是对分离的GNB最敏感的药物,氨苄西林5.7%是最不敏感的药物。值得注意的是,阿米卡星是对所有分离的GNB最敏感的药物,氨苄西林是对所有分离的GNB最不敏感的药物。
    这项研究报告了一个中等的尿路病原体分离率为41.8%。金黄色葡萄球菌和大肠杆菌是最常见的细菌,其中大部分来自女性患者。值得注意的是,阿米卡星是对分离的GNB和GPB最敏感的药物。
    UNASSIGNED: Urinary tract infections exert a significant negative impact on an individual\'s quality of life and cause significant economic and public health burdens. Therefore, this study was conducted to identify the common bacterial uropathogens associated with urinary tract infections in Wad Medani patients and their susceptibility to antibiotics.
    UNASSIGNED: This was a cross-sectional study. All urine samples were collected from patients at Wad Medani and investigated at the Pathology Center for Diagnosis and Research, Faculty of Medicine, University of Gezira, Sudan, from the 1st of January 2021 to the 15th of October 2023.
    UNASSIGNED: A total of 2698 urine samples were analyzed during the three years study period, with a mean age of 45.29 ± 18.9 years. Among these patients, 1108 (41.8%) were positive for bacterial growth, and 888 (80.14%) were female. A total of 522 (47.1%) were gram positive bacteria (GPB), and 586 (52.9%) were gram negative bacteria (GNB). The most frequently isolated bacteria were S. aureus 42% (465/1108) and E. coli 38.5% (427/1108), while P. aeruginosa was less detected 3.4% (38/1108). Amikacin 91.5% was the most sensitive drug to isolated GPB, while cotrimoxazole 20.9% was the least sensitive drug. In particular, amikacin 94.1% (144/153) was the most sensitive drug to S. aureus, while cotrimoxazole 20.7% (80/386) was the least sensitive drug. Moreover, amikacin 91.5% was the most sensitive drug to the isolated GNB, while ampicillin 5.7% was the least sensitive drug. Notably, amikacin was the most sensitive drug to all the isolated GNB, and ampicillin was the least sensitive drug to all the isolated GNB.
    UNASSIGNED: This study reported a moderate uropathogen isolation rate of 41.8%. S. aureus and E. coli were the most frequently isolated bacteria, most of which were from female patients. Remarkably, amikacin was the most sensitive drug to isolated GNB and GPB.
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  • 文章类型: Journal Article
    我们的目标是量化糖尿病患者中经常引起UTI的各种细菌的数量,并评估其对抗生素的敏感性和耐药性。
    在雷丁夫人医院的内科病房进行了一项横断面研究,白沙瓦,巴基斯坦从2021年6月至2021年12月,确诊糖尿病的患者被纳入研究;然而,接受抗菌药物治疗最多14天的参与者被排除在研究之外.大肠杆菌的耐药性,念珠菌,假单胞菌,E.粪便,克雷伯菌属,奇异假单胞菌和葡萄球菌用环丙沙星检测,头孢他啶和美罗培南.
    研究结果强调了38.8%的患者中大肠杆菌的患病率,19%的患者中的念珠菌,11.8%的患者粪肠球菌,假单胞菌在10%,9.5%的患者出现克雷伯菌,奇异变形杆菌6.2%患者,葡萄球菌5.2%患者。根据微生物对抗生素的总体敏感性和耐药性,美罗培南的敏感性为89.6%,耐药性为10.4%。环丙沙星敏感性为38.9%,耐药率为61.1%,头孢他啶敏感性为22.7,耐药率为77.3%。
    尿路感染在糖尿病患者中非常常见,大肠杆菌是发现的最常见的尿路病原体。与男性患者相比,更多的女性患者感染。尿路病原菌对头孢替啶和环丙沙星有明显的耐药性。
    UNASSIGNED: Our objective was to quantify the number of various bacteria that frequently cause UTI in diabetes patients as well as to gauge their susceptibility and resistance to antibiotics.
    UNASSIGNED: A cross-sectional study was conducted at the Internal Medicine Ward of Lady Reading Hospital, Peshawar, Pakistan from June 2021 to December 2021, Patients with confirmed diabetes were included in the study; however, participants receiving antimicrobial medications for a maximum of 14 days were excluded from the study. Resistance of Escherichia coli, Candida, Pseudomonas, E. faecalis, Klebsiella, P. mirabilis and Staphylococcus was asssessed using ciprofloxac, ceftazidime and meropenem.
    UNASSIGNED: The findings highlighted the the prevalence of Escherichia coli in 38.8% of patients, Candida in 19% of patients, Enterococcus faecalis in 11.8% of patients, Pseudomonas in 10%, Klebsiella in 9.5% patients, Proteus mirabilis 6.2% patients and Staphylococcus was found in 5.2% patients. According to the overall sensitivity and resistance of antibiotics in microorganisms, Meropenem showed 89.6% sensitivity and 10.4% resistance. Ciprofloxacin showed 38.9% sensitivity and 61.1% resistance and ceftazidime showed 22.7 sensitivity and 77.3% resistance.
    UNASSIGNED: UTIs were very common in diabetes patients, and Escherichia coli was the most common uropathogen found. Compared to male patients, more female patients had infections. The uropathogens showed a significant degree of resistance to ceftizidime and ciprofloxacin.
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  • 文章类型: Journal Article
    尿路感染(UTI)是全球最常见的细菌感染之一。UTI的主要致病因子是尿路致病性大肠杆菌(UPEC)。由于尿病原体中抗菌素耐药性的发生率增加,因此迫切需要针对UTI的新型预防和治疗策略。ABU83972,一种无症状的细菌尿症引起的大肠杆菌菌株,通过抑制UPEC的定植来预防UTI。然而,ABU83972对UPEC的竞争和生长抑制的性质尚不清楚,这是我们调查的主题。这里,我们表征了ABU83972和尿路病原体在人尿液和实验室培养基中的生长动力学。接下来,我们进行了一系列竞争性共培养实验,其中ABU83972和尿路病原体以1:1的比例接种在人尿和各种培养基中,并确定了它们的相对丰度。在人体尿液中,ABU83972胜过UPEC和其他尿路病原体,孵化24小时后达到总人口的90%。相比之下,UPEC在LB和M9基本培养基中胜过ABU83972,并且在小鼠膀胱中表现出比ABU83972更好的定植。由于工程活体材料(ELM)可用于将感兴趣的生物体保留在特定位置,我们开发了含有ABU83972的ELM,其在人尿中的竞争效果优于UPEC.总之,我们的工作确定ABU83972以环境和细胞密度依赖的方式胜过UPEC,强调人体尿液中发现的代谢物和营养素作为ABU83972竞争适应性决定因素的重要性。
    Urinary tract infection (UTI) is one of the most common bacterial infections worldwide. The main causative agent of UTI is uropathogenic Escherichia coli (UPEC). There is an immediate need for novel prophylactic and treatment strategies against UTI because of the increasing incidence of antimicrobial resistance among uropathogens. ABU 83972, an asymptomatic bacteriuria-causing E. coli strain, prevents UTI by suppressing the colonization of UPEC. However, the nature of competition and growth repression of UPEC by ABU 83972 is unclear and is the subject of our investigation. Here, we characterized the growth kinetics of ABU 83972 and uropathogens in human urine and laboratory media. Next, we performed a series of competitive co-culture experiments where ABU 83972 and uropathogens were inoculated at a 1:1 ratio in human urine and in various media, and their relative abundance was determined. In human urine, ABU 83972 outcompeted UPEC and additional uropathogens, reaching up to 90% of the total population after 24 hours of incubation. In contrast, UPEC outcompeted ABU 83972 in LB and M9 minimal media and exhibited superior colonization than ABU 83972 in the mouse urinary bladder. Since engineered living materials (ELMs) can be used to retain an organism of interest in a particular location, we developed ABU 83972-containing ELMs that effectively outcompeted UPEC in human urine. In summary, our work establishes that ABU 83972 outcompetes UPEC in a milieu- and cell-density-dependent manner, highlighting the importance of the metabolites and nutrients found in the human urine as determinants of the competitive fitness of ABU 83972.
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  • 文章类型: Journal Article
    背景:缺乏关于尿路感染复发的尿路病原体的抗生素耐药性的数据。
    方法:在2016年01月至2020年12月12日期间,在南加州KaiserPermanente进行了一项成人回顾性队列研究,研究了随后的文化确认的UTI的数量和特征。
    结果:我们确定了148,994名具有文化确认指数uUTI的个体(88%为女性,44%的西班牙裔,平均年龄51岁[s.d.19]),其中19%在中位数300天后发展为随后的培养证实的UTI(IQR:126-627)。由于大肠杆菌引起的UTI的比例对于指数uUTI最高(79%),对于第六个UTI(UTI6)下降到73%(趋势p<0.001),而克雷伯菌属的比例从UTI指数(7%)增加到UTI6指数(11%)(趋势p<0.001)。在57%和13%的指标uUTI中观察到对≥1和≥3种抗生素类别的不敏感性,分别,并且在随后的UTI中更高(65%和20%,分别,对于UTI6)。最常见的抗生素非敏感性模式包括单独的青霉素(12%),还有青霉素,甲氧苄啶-磺胺甲恶唑加≥1个额外的抗生素类(9%)。
    结论:抗生素非敏感性在尿路感染中是常见的,并随着随后的尿路感染而增加。需要持续监测UTI复发和易感性模式以指导治疗决策。
    BACKGROUND: Data on antibiotic resistance of uropathogens for UTI recurrences are lacking.
    METHODS: In a retrospective cohort of adults at Kaiser Permanente Southern California with culture-confirmed index uncomplicated UTI (uUTI) between 01/2016 and 12/2020, we examined the number and characteristics of subsequent culture-confirmed UTIs through 2021.
    RESULTS: We identified 148,994 individuals with a culture-confirmed index uUTI (88% female, 44% Hispanic, mean age 51 years [s.d. 19]), of whom 19% developed a subsequent culture-confirmed UTI after a median 300 days (IQR: 126-627). The proportion of UTI due to E. coli was highest for index uUTI (79%) and decreased to 73% for sixth UTI (UTI 6) (p-for trend <0.001), while the proportion due to Klebsiella spp increased from index UTI (7%) to UTI 6 (11%) (p-for-trend <0.001). Non-susceptibility to ≥1 and ≥3 antibiotic classes was observed in 57% and 13% of index uUTIs, respectively, and was higher for subsequent UTIs (65% and 20%, respectively, for UTI 6). Most commonly observed antibiotic non-susceptibility patterns included penicillins alone (12%), and penicillins, trimethoprim-sulfamethoxazole plus ≥1 additional antibiotic class (9%).
    CONCLUSIONS: Antibiotic non-susceptibility is common in UTIs and increases with subsequent UTIs. Continuous monitoring of UTI recurrences and susceptibility patterns are needed to guide treatment decisions.
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  • 文章类型: Journal Article
    背景:尿路感染(UTI)是最常见的感染之一,可引起许多肾脏系统并发症。这项研究旨在评估Al-MadinahAl-Munawarah的尿路病原体的患病率及其对抗生素的敏感性模式,沙特阿拉伯。
    方法:数据来自在Al-MadinahAl-Munawarah的KingFahadGeneralHospital就诊的UTI患者,沙特阿拉伯。在这项回顾性横断面研究中,使用自动化系统确定的UTI微生物致病因子和抗菌素耐药性概况,Phoenix和VITEK2是在2022年7月至2023年6月之间收集的。此外,最少的人口统计数据,包括收集日期和患者的性别和年龄,并使用卡方检验进行分析。
    结果:该研究包括1394名UTI阳性患者,包括50.57%的男性和49.43%的女性(卡方拟合优度,p>0.999)。对UTI阳性培养物进行微生物鉴定和抗菌药物敏感性试验。在UTI中,单一感染,由单一病原体引起,是最普遍的,占病例的88.16%,而多感染(由多种病原体引起)占11.9%。最普遍的UTI病原体是大肠杆菌(30.59%),其次是肺炎克雷伯菌(21.40%),粪肠球菌(8.46%),铜绿假单胞菌(7.81%),无乳链球菌(6.35%),屎肠球菌(3.01%),奇异变形杆菌(3.01%),阴沟肠杆菌(2.52%),念珠菌sp.(2.44%),鲍曼不动杆菌(1.95%),金黄色葡萄球菌(1.79%),产气肠杆菌(1.30%)。与其他尿路病原体共存导致尿路感染的最主要病原体是肺炎克雷伯菌和奇异疟原虫(9.32%,卡方5.550,p=0.018),肺炎克雷伯菌和铜绿假单胞菌(8.07%,卡方6.285,p=0.012),肺炎克雷伯菌和粪肠球菌(7.45%,卡方5.785,p=0.016),念珠菌sp.和屎肠球菌(4.97%,卡方9.176,p=0.002,念珠菌。和鲍曼不动杆菌(3.11%,卡方4.312,p=0.038))。在尿路病原体中,革兰氏阴性病原体对大多数测试的抗微生物剂(氨苄青霉素,头孢菌素,氟喹诺酮类药物,甲氧苄啶-磺胺甲恶唑,氨曲南,和呋喃妥因)。对头孢菌素的耐药率很高,阿莫西林-克拉维酸,和甲氧苄啶-磺胺甲恶唑.
    结论:本研究报告了Al-MadinahAl-Munawarah的UT单感染和多感染,沙特阿拉伯,主要来自革兰氏阴性细菌,肠杆菌科。大多数UT微生物菌株表现出高度抗性。
    BACKGROUND: Urinary tract infections (UTIs) are among the most common infections and can cause numerous complications of the renal system. This study aimed to assess the prevalence of uropathogens and their antibiotic susceptibility patterns in Al-Madinah Al-Munawarah, Saudi Arabia.
    METHODS: Data was collected from patients with UTIs presented at King Fahad General Hospital in Al-Madinah Al-Munawarah, Saudi Arabia. In this retrospective cross-sectional study, UTI microbial-causing agents and antimicrobial resistance profiles identified using automated systems, Phoenix and VITEK2, were collected between July 2022 and June 2023. In addition, minimal demographic data, including date of collection and sex and age of patients were collected and analyzed using Chi-square test.
    RESULTS: The study included 1394 patients positive for UTI, comprising 50.57% males and 49.43% females (chi-square goodness-of-fit, p > 0.999). Microbial identification and antimicrobial susceptibility tests were performed on UTI-positive cultures. Among UTIs, mono-infection, caused by a single pathogen, was the most prevalent, accounting for 88.16% of cases, whereas poly-infection (caused by multiple pathogens) presented at 11.9%. The most prevalent UTIs\' pathogens were E. coli (30.59%), followed by Klebsiella pneumoniae (21.40%), Enterococcus faecalis (8.46%), Pseudomonas aeruginosa (7.81%), Streptococcus agalactiae (6.35%), Enterococcus faecium (3.01%), Proteus mirabilis (3.01%), Enterobacter cloacae (2.52%), Candida sp. (2.44%), Acinetobacter calcoaceticus-baumannii (1.95%), Staphylococcus aureus (1.79%), and Enterobacter aerogenes (1.30%). The most dominant pathogens that coexisted with other uropathogens to cause UTIs were K. pneumoniae and P. mirabilis (9.32%, chi-square 5.550, p = 0.018), K. pneumoniae and P. aeruginosa (8.07%, chi-square 6.285, p = 0.012), K. pneumoniae and E. faecalis (7.45%, chi-square 5.785, p = 0.016), Candida sp. and Enterococcus faecium (4.97%, chi-square 9.176, p = 0.002, and Candida sp. and Acinetobacter calcoaceticus-baumannii (3.11%, chi-square 4.312, p=0.038)). Among the uropathogens, gram-negative pathogens showed resistance to most of the tested antimicrobials (ampicillins, cephalosporins, fluoroquinolones, trimethoprim-sulfamethoxazole, aztreonam, and nitrofurantoin). High rates of resistance were identified to cephalosporins, amoxicillin-clavulanic acid, and trimethoprim-sulfamethoxazole.
    CONCLUSIONS: This study reported UT mono-infection and poly-infection in Al-Madinah Al-Munawarah, Saudi Arabia, with a predominant representation from gram-negative bacteria, Enterobacteriaceae. Most of the UT microbial strains showed a highly resistant profile.
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  • 文章类型: Journal Article
    尿路感染是兽医实践中的狗的常见诊断。兽医经常凭经验治疗可疑感染,无论是在没有培养和敏感性测试结果的情况下,还是在等待它们的时候。这项研究旨在鉴定昆士兰东南部(SEQ)中最常从犬尿样本中分离出的细菌及其抗菌药物敏感性模式,以帮助指导该地理位置的兽医界负责任的经验性抗菌药物处方。从SEQ,在5年内从商业兽医实验室获得。大肠杆菌是最常见的细菌种类(43%),其次是葡萄球菌。(23%),变形杆菌。(21%)和肠球菌属。(10%)。在六种最常见的分离株中,97%的人对至少一种低重要性的抗菌药物敏感。对低重要性和一线抗菌药物建议的敏感性,阿莫西林,大肠杆菌为81%,葡萄球菌为24%。大肠杆菌和葡萄球菌的易感性。对于中等重要性和通常推荐的经验性抗菌药物,高重要性抗菌药物恩诺沙星和头孢噻呋胺的甲氧苄啶和阿莫西林-克拉维酸≥85%和>92%。大肠杆菌和葡萄球菌属。隔离物,8.8%和4%,分别,被认为是多重耐药的。在研究期间没有检测到对抗菌药物的抗性增加。敏感性表明低和中重要性的抗菌药物仍然是可接受的一线经验治疗。然而,应使用当地监测数据不断评估和更新。
    Urinary tract infections are a common diagnosis in dogs presenting to veterinary practice. Veterinarians often treat suspected infections empirically, either in the absence of culture and susceptibility testing results or whilst waiting for them. This study aimed to identify the bacteria most frequently isolated from canine urinary samples and their antimicrobial susceptibility patterns in South East Queensland (SEQ) to help guide responsible empirical antimicrobial prescription by the veterinary community in this geographical location. Cumulative antibiograms were generated from the results of 1284 culture-positive urinary samples in SEQ, obtained from a commercial veterinary laboratory over a 5-year period. Escherichia coli was the most commonly isolated bacterial species (43%), followed by Staphylococcus spp. (23%), Proteus spp. (21%) and Enterococcus spp. (10%). Of the six most common isolates, 97% had susceptibility to at least one low-importance antimicrobial. Susceptibility to the low-importance and first-line antimicrobial recommendation, amoxicillin, was 81% for E. coli and 24% for Staphylococcus spp. Susceptibility of both E. coli and Staphylococcus spp. to medium-importance and commonly recommended empirical antimicrobials, trimethoprim sulphonamides and amoxicillin-clavulanic acid was ≥85% and >92% for high-importance antimicrobials enrofloxacin and ceftiofur. Of the E. coli and Staphylococcus spp. isolates, 8.8% and 4%, respectively, were considered multidrug resistant. There was no increase in resistance to antimicrobials detected over the study period. Susceptibilities suggest low- and medium-importance antimicrobials remain acceptable first-line empirical treatments. However, this should be continually assessed and updated using local surveillance data.
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  • 文章类型: Journal Article
    由抗生素抗性细菌引起的尿路感染(UTI)在狗中很常见,导致宠物动物以及人类健康的严重健康影响。了解流行的尿路病原体及其药物敏感性对于通过实施管理政策来限制抗菌素耐药性至关重要。鉴于此,本研究旨在从犬UTI临床病例中确定流行的细菌性尿路病原体及其抗菌谱。从35只具有UTI临床症状的狗中收集尿液样品,共回收了27种细菌分离株。其中大肠杆菌是最主要的分离株,其次是产气克雷伯菌,金黄色葡萄球菌,变形杆菌,肠球菌。和freundii柠檬酸杆菌.发现所有分离株对共识指南推荐的一种或多种一线抗生素具有耐药性,并且总分离株的70%表现出多药耐药性。此外,这项研究根据共识指南评估了经验性治疗相对于抗菌药物敏感性试验指导治疗的权重.选择患有不复杂UTI的狗并将其分为三个不同的组(n=6)。第1组接受常规经验选择阿莫西林-克拉维酸治疗,第2组保留对环丙沙星敏感的狗,并用环丙沙星和尿碱化剂柠檬酸氢二钠治疗。将呋喃妥因易感病例保留在第3组中,并使用呋喃妥因和尿酸剂氯化铵联合治疗。评估了治疗结果,第2组和第3组的成功率高于第1组,这表明在现有情况下,使用当地或机构的抗菌谱数据选择抗生素比公认的国际指南更为周到。
    Urinary tract infection (UTI) caused by antimicrobial resistant bacteria is common in dogs leading to serious health impact in pet animal as well as on human health. Understanding the prevalent uropathogens and their drug susceptibility is essential for limiting the antimicrobial resistance through implementation of stewardship policies. In view of this, present study was envisaged to determine the prevalent bacterial uropathogens and their antibiogram from clinical cases of canine UTI. Urine samples were collected from 35 dogs presented with clinical signs of UTI and a total of 27 bacterial isolates were recovered. Among that Escherichia coli was the most predominant isolate followed by Klebsiella aerogenes, Staphylococcus aureus, Proteus mirabilis, Enterococcus sp. and Citrobacter freundii. All isolates were found resistant to one or more 1st line antibiotics recommended by consensus guidelines and 70% of total isolates showed multidrug resistance. Additionally, this study evaluated the weightage of empirical therapy as per the consensus guidelines over antimicrobial susceptibility test guided treatment. Dogs with uncomplicated UTI were selected and categorized into three different groups (n = 6). Group 1 was treated with common empirical choice amoxycillin-clavulanic acid and dogs showed susceptible to ciprofloxacin were kept in Group 2 and treated with ciprofloxacin along with urinary alkalizer disodium hydrogen citrate. Nitrofurantoin susceptible cases were kept in Group 3 and treated with a combination of nitrofurantoin and urinary acidifier ammonium chloride. Therapeutic outcome was evaluated and success rate was higher in Group 2 and 3 than Group 1 suggested that selection of antibiotics with the use of local or institutional antibiogram data is more considerate than acknowledged international guidelines in the existing situation.
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  • 文章类型: Journal Article
    尿路感染(UTI)是最常见的细菌感染,由于抗菌素耐药性(AMR)的增加,构成了重大的公共卫生挑战。这项研究旨在评估患病率,人口特征,微生物概况,以及重症监护病房的印度尿路感染患者的抗菌素耐药模式。共有154名尿路感染阳性的患者被纳入这项横断面研究。患病率数据包括人口统计数据,微生物分离,并收集抗菌药物敏感性模式。此外,使用多变量分析评估了多药耐药尿路病原体的危险因素.患者队列有不同的人口统计学,男性占52.6%(n=81)。最常见的合并症是高血压59.1%(n=91)和糖尿病54.5%(n=84)。微生物分布以革兰氏阴性菌为主,尤其是大肠埃希菌26.62%(n=41)和肺炎克雷伯菌17.53%(n=27)。主要的革兰氏阳性和真菌分离物是屎肠球菌7.14%(n=11)和念珠菌。18.83%(n=29),分别。对常见的抗菌素有明显的耐药性,不同病原体之间的差异。革兰氏阴性菌,特别是大肠杆菌和肺炎克雷伯菌,表现出很高的MDR率,强调抗菌素耐药性的挑战。多变量逻辑回归将50-65岁及65岁以上的年龄组和延长的导管插入术确定为MDR感染的重要危险因素。病原体中显著高的耐药率强调了明智使用抗微生物剂的必要性。我们的研究结果强调了基于当地病原体患病率和抗菌谱数据的持续监测和量身定制的干预措施的必要性,以有效地应对AMR威胁的威胁,从而更好地管理ICU环境中的UTI管理。
    Urinary tract infections (UTIs) are among the most common bacterial infections, posing significant public health challenges due to increasing antimicrobial resistance (AMR). This study aims to assess the prevalence, demographic characteristics, microbial profile, and antimicrobial resistance patterns in Indian patients with UTIs admitted to intensive care unit. A total of 154 patients with positive UTIs were included in this cross-sectional study. The prevalence data including demographics, microbial isolates, and antimicrobial susceptibility patterns were collected. Additionally, risk factors for multidrug resistance uropathogens were assessed using multivariate analyses. The patient cohort had diverse demographic, with a slight male predominance of 52.6% (n = 81). The most common comorbidities were hypertension 59.1% (n = 91) and diabetes mellitus 54.5% (n = 84). The microbial profile was dominated by gram-negative bacteria, particularly Escherichia coli 26.62% (n = 41) and Klebsiella pneumoniae 17.53% (n = 27). The predominant gram-positive and fungal isolate was Enterococcus faecium 7.14% (n = 11) and Candida spp. 18.83% (n = 29), respectively. Substantial resistance was noted against common antimicrobials, with variations across different pathogens. Gram-negative bacteria, particularly Escherichia coli and Klebsiella pneumoniae, exhibited high MDR rates, emphasizing the challenge of antimicrobial resistance. Multivariate logistic regression identified age groups 50-65 and over 65, and prolonged catheterization as significant risk factors for MDR infections. A significantly high resistance rate among pathogens emphasizes the need for judicious antimicrobial use. Our findings emphasize the necessity of ongoing surveillance and tailored interventions based on local pathogen prevalence and antibiogram data to effectively address the threat of AMR threat for better management of UTI management in ICU settings.
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  • 文章类型: Letter
    泌尿系统疾病影响所有年龄段,并与不同的泌尿系统并发症有关。病原菌的存在使泌尿系统疾病如慢性肾病(CKD)复杂化,肾结石病(KSD),气肿性肾盂肾炎(EPN),和泌尿系癌症(UC)与泌尿代谢并发症相吻合。防止抗生素耐药性机会病原体传播的“一个健康”概念需要对尿路感染(UTI)病原体的毒力和抗生素敏感性模式进行详细调查。这项横断面研究旨在分析与不同泌尿系统疾病相关的病原菌,其中包括三级医院患者的尿液样本。该研究包括258例CKD患者(15.1%),KSD(28.7%),EPN(15.5%),UC(12.0%),和UTI患者无任何泌尿系统疾病(28.7%),总体70.5%的患者尿培养阳性。此外,除UTI外,没有任何泌尿系统疾病的患者(100%),在KSD中观察到较高的培养阳性病例(64.9%),其次是CKD(61.5%),EPN(52.5%),和UC(48.4%)。大肠杆菌是UTI(35.1%)和EPN(66.7%)中最主要的细菌。在KSD,铜绿假单胞菌(41.7%),金黄色葡萄球菌(18.8%),奇异变形杆菌(14.6%)更为常见。金黄色葡萄球菌(86.7%)是UC病例中最分离的细菌。多药耐药(MDR)总发生率为77.8%。所有(100%)大肠杆菌,肺炎克雷伯菌,P.奇迹,金黄色葡萄球菌菌株为MDR。在菌株中,在73.6%中观察到强烈的生物膜形成,66.7%的菌株为脲酶阳性。生物膜与MDR和脲酶活性呈正相关。泌尿系统疾病中细菌的丰度和分布有所不同,表明它们与尿液代谢物谱有关。泌尿系统疾病患者中MDR病原体的定植是一个严重的问题,需要采取步骤来控制耐药性的出现及其进一步传播到生态系统中。
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  • 文章类型: Journal Article
    儿童尿路感染(UTI)很常见,并伴有相当大的急性发病率和长期并发症。需要更新的数据来优化经验性抗生素治疗是至关重要的。我们旨在调查引起儿科社区获得性UTI的病原体,它们与人口统计学特征的相关性,以及抗菌素耐药性的趋势。这项全国性的横断面研究包括以下选定年份在社区门诊诊断为UTI的所有53,203名儿童(<18岁):2007年,2011年,2015年,2019年和2021年。大肠杆菌(E.大肠杆菌)(82.1%)是最常见的尿路病原体,其次是肠杆菌,克雷伯菌属,Proteus,假单胞菌,和肠球菌。细菌分布显示出统计学上显着(p<0.0001)的性别和部门特异性模式,非E的相对患病率更高。犹太人和男性的大肠杆菌UTI。超广谱β-内酰胺酶阳性大肠杆菌的比率从2007年的6.1%显著增加到2021年的25.4%(p<0.001)。大多数非E。大肠埃希菌对儿童尿路感染的常用经验性抗生素表现出耐药性。这些发现对于指导儿科社区获得性UTI的最佳经验性抗生素治疗具有重要意义。尿路病原体对抗菌药物的耐药性是区域和时间依赖性的。因此,定期和局部评估抗生素耐药性趋势对于更新指南和为患有UTI的儿童提供最合适的抗菌治疗至关重要.
    Urinary tract infections (UTIs) in childhood are common and are associated with considerable acute morbidity and long-term complications. The need for updated data to optimize empiric antibiotic therapy is crucial. We aimed to investigate the pathogens causing pediatric community acquired UTIs, their correlation with demographic characteristics, and trends in their antimicrobial resistance. This nationwide cross-sectional study included all 53,203 children (<18 years) diagnosed with UTI in community outpatient clinics in the following selected years: 2007, 2011, 2015, 2019 and 2021. Escherichia coli (E. coli) (82.1%) was the most common uropathogen, followed by Enterobacter, Klebsiella, Proteus, Pseudomonas, and Enterococcus species. The bacterial distribution displayed statistically significant (p < 0.0001) gender- and sector-specific patterns with a higher relative prevalence of non-E. coli UTI in Jewish and males. The rate of extended-spectrum beta-lactamase-positive E. coli increased substantially and significantly (p < 0.001) from only 6.1% in 2007 to 25.4% in 2021. Most non-E. coli uropathogens exhibited resistance to commonly used empiric antibiotics for UTIs in children. These findings are significant in guiding optimal empiric antibiotic treatment for pediatric community acquired UTIs. The resistance of uropathogens to antimicrobials is region- and time-dependent. Therefore, the periodic and local assessment of antibiotic resistance trends is essential to update guidelines and provide the most appropriate antibacterial therapy for children with UTIs.
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