大肠杆菌的表型特征与免疫受损患者的尿路感染复发之间的关联:一个病例控制研究
Arturo Reyes-Gualito1, Alejandro E Macías2, Lourdes Reyes-Escogido2
1Hospital Regional de Alta Especialidad del Bajío, Departamento de investigación. Secretaría de Salud, Leon, Guanajuato, Mexico; Universidad de Guanajuato, Departamento de Medicina y Nutrición, Leon, Guanajuato, Mexico.
American journal of infection control
|August 25, 2023
概括
大肠杆菌中的细丝细胞形态与免疫受损患者的复发性尿路感染 (UTI) 有关. 这一发现可能有助于诊断复发性尿路感染和抗菌素耐药性.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 复发性尿路感染 (UTI) 在免疫功能低下的人群中构成重大挑战.
- 大肠杆菌是尿路感染的主要致病原体,其毒性因子越来越多地受到研究.
- 了解大肠杆菌的表型特征对于在脆弱人群中诊断复发性尿路感染至关重要.
研究的目的:
- 调查大肠杆菌的特定表型特征与免疫受损患者尿路感染复发之间的关联.
- 评估大肠杆菌丝状细胞形态的诊断潜力,粘菌体殖民地表型,并在反复性尿路感染中产生生物膜.
主要方法:
- 在墨西哥Bajío地区高级专科医院 (Regional Hospital de Alta Especialidad del Bajío) 进行了一项对免疫功能低下患者的病例控制研究.
- 确定了大肠杆菌菌株,并进行了抗菌感受性测试.
- 评估了表型特征 (丝状细胞形态,粘膜菌群,生物膜产生),并使用几率比率量化了它们与尿路感染复发的关联.
主要成果:
- 在大肠杆菌的细丝细胞形态和尿路感染复发之间发现了显著的关联 (OR = 2.19,P = 0.031).
- 在粘膜体殖民地形态或生物膜生成和尿路感染复发 (P > .05) 之间没有发现显著的关联.
- 粘膜菌群形态显示与扩展光谱β-乳酸酶 (ESBL) 生产有关 (OR = 3.09,P < .001).
结论:
- 大肠杆菌中的纤维状细胞形态可能作为免疫受损患者中复发性尿路感染的潜在诊断标志物.
- 粘膜体殖民现象也可能与检测抗菌素耐药性,特别是ESBL生产有关.
- 需要进一步的研究来证实这些表型特征在诊断测试中的临床实用性.
相关概念视频
01:25Urinary Tract Infection II: Pathophysiology
18
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
18
01:26Urine Studies II: Urine Culture and Sensitivity Test
54
A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
54
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
15
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
15
01:26Urinary Tract Infection I: Introduction
24
Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
24
01:17Urinary Tract Infection IV: Nursing Management
24
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
24
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
17
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
17