危急病患COVID-19的尿管感染:一个回顾性队列研究
Paulina Dąbrowska1, Mateusz Bartoszewicz1, Klaudia Bartoszewicz2
1Department of Anaesthesiology and Intensive Care, Medical University of Bialystok, Bialystok, Poland.
Therapeutic advances in infectious disease
|October 7, 2024
概括
导管相关的尿路感染 (CA-UTIs) 是常见的COVID-19患者在ICU,导致更长的住院时间和更高的死亡率. 有效的感染控制和有针对性的治疗对于管理这些感染至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 临界护理医学 临界护理医学
- 微生物学 微生物学
背景情况:
- 导管相关的尿路感染 (CA-UTIs) 是一个重大的临床挑战,特别是在重症监护室 (ICU) 的COVID-19患者.
- 了解这种脆弱人群中CA-UTIs的流行病学和风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 确定COVID-19的ICU患者中CA-UTI的流行率和发病密度.
- 识别常见的致病原体及其抗微生物耐药性模式.
- 确定与CA-UTIs相关的风险因素和临床结果.
主要方法:
- 进行了一项回顾性队列研究,涉及201名COVID-19的成年ICU患者.
- 患者被分为CA-UTI (n=56) 和非CA-UTI (n=145) 组.
- 使用后勤回归分析来确定CA-UTI发展的风险因素.
主要成果:
- CA-UTIs发生在28%的患者中,发病率密度为每1000个导管日中有15.8次.
- 患有CA-UTI的患者经历了显著更长的ICU停留时间 (18.8 vs 10.5天) 和更高的死亡率 (75.0% vs 54.5%).
- 最常见的病原体是Klebsiella pneumoniae,多重耐药性 (38.8%) 的流行率很高,包括ESBL,MBL,NDM和OXA-48生产商. 总体而言,MDR生物体的发生率为68.8%.
结论:
- 在COVID-19的ICU患者中,CA-UTIs很普遍,并且与不良结果有关,包括长时间的ICU停留和增加的死亡率.
- 这项研究突出了这一患者群体中CA-UTIs中多药耐药生物体的重大负担.
- 实施强有力的感染控制措施和明智的抗微生物管理对于减轻CA-UTIs对重症COVID-19患者的影响至关重要.
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