• Something wrong with this record ?

The prevalence of antibiotic-resistant and multidrug-resistant bacteria in urine cultures from inpatients with spinal cord injuries and disorders: an 8-year, single-center study

V. Šámal, V. Paldus, D. Fáčková, J. Mečl, J. Šrám

. 2022 ; 22 (1) : 239. [pub] 20220309

Language English Country Great Britain

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc22010776

BACKGROUND: Patients, especially inpatients, with spinal cord lesions and disorders (SCI/D) have an elevated risk of recurrent urinary tract infections with multidrug resistant (MDR) bacteria. This study evaluated antimicrobial resistance and the prevalence of multidrug resistance and determined the risk factors for multidrug resistance. METHODS: In this retrospective cohort study, urine culture results were used to calculate the antimicrobial resistance rate and the incidence of infection with MDR bacteria in the SCI/D population. MDR was defined as acquired nonsusceptibility to at least one agent from three or more antimicrobial categories. The cohort included 402 inpatients from 2013 to 2020, with 1385 urine isolates. We included only the first isolate; duplicate isolates, defined as positive cultures of the same strain within 14 days, were excluded from the evaluation. RESULTS: The most common MDR strains were Klebsiella spp. (29%) and Escherichia coli (24%). MDR isolates were detected in 50% of the samples and extended spectrum beta-lactamase (ESBL)-producing isolates were detected in 26%, while carbapenem resistance was found in 0.1%. Significantly higher rates of infection with MDR bacteria were identified in groups of patients with indwelling urethral/suprapubic catheters (p = 0.003) and severity scores of C1-C4/AIS A-C (p = 0.01). We identified age (OR: 0.99, 95% CI; 0.98-0.99, p = 0.000), sex (OR: 1.55, 95% CI; 1.16-2.06, p = 0.003), management with urethral/suprapubic catheters (OR: 2.76, 95% CI; 2.04-3.74, p = 0.000), and spontaneous voiding (OR: 1.84, 95% CI; 1.03-3.29, p = 0.038) as independent predictors of multidrug resistance in our study population. CONCLUSIONS: We identified a high antibiotic resistance rate and an increasing prevalence of infection with MDR bacteria in the SCI/D inpatient population. Particular attention should be given to bladder management, with an emphasis on minimizing the use of indwelling catheters.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc22010776
003      
CZ-PrNML
005      
20220506130419.0
007      
ta
008      
220425s2022 xxk f 000 0|eng||
009      
AR
024    7_
$a 10.1186/s12879-022-07235-3 $2 doi
035    __
$a (PubMed)35264096
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxk
100    1_
$a Šámal, Vladimír $u Department of Urology, Krajská Nemocnice Liberec, Husova 10, 46063, Liberec, Czech Republic. vladimir.samal@nemlib.cz $1 https://orcid.org/0000000200819986
245    14
$a The prevalence of antibiotic-resistant and multidrug-resistant bacteria in urine cultures from inpatients with spinal cord injuries and disorders: an 8-year, single-center study / $c V. Šámal, V. Paldus, D. Fáčková, J. Mečl, J. Šrám
520    9_
$a BACKGROUND: Patients, especially inpatients, with spinal cord lesions and disorders (SCI/D) have an elevated risk of recurrent urinary tract infections with multidrug resistant (MDR) bacteria. This study evaluated antimicrobial resistance and the prevalence of multidrug resistance and determined the risk factors for multidrug resistance. METHODS: In this retrospective cohort study, urine culture results were used to calculate the antimicrobial resistance rate and the incidence of infection with MDR bacteria in the SCI/D population. MDR was defined as acquired nonsusceptibility to at least one agent from three or more antimicrobial categories. The cohort included 402 inpatients from 2013 to 2020, with 1385 urine isolates. We included only the first isolate; duplicate isolates, defined as positive cultures of the same strain within 14 days, were excluded from the evaluation. RESULTS: The most common MDR strains were Klebsiella spp. (29%) and Escherichia coli (24%). MDR isolates were detected in 50% of the samples and extended spectrum beta-lactamase (ESBL)-producing isolates were detected in 26%, while carbapenem resistance was found in 0.1%. Significantly higher rates of infection with MDR bacteria were identified in groups of patients with indwelling urethral/suprapubic catheters (p = 0.003) and severity scores of C1-C4/AIS A-C (p = 0.01). We identified age (OR: 0.99, 95% CI; 0.98-0.99, p = 0.000), sex (OR: 1.55, 95% CI; 1.16-2.06, p = 0.003), management with urethral/suprapubic catheters (OR: 2.76, 95% CI; 2.04-3.74, p = 0.000), and spontaneous voiding (OR: 1.84, 95% CI; 1.03-3.29, p = 0.038) as independent predictors of multidrug resistance in our study population. CONCLUSIONS: We identified a high antibiotic resistance rate and an increasing prevalence of infection with MDR bacteria in the SCI/D inpatient population. Particular attention should be given to bladder management, with an emphasis on minimizing the use of indwelling catheters.
650    _2
$a antibakteriální látky $x farmakologie $x terapeutické užití $7 D000900
650    _2
$a mnohočetná bakteriální léková rezistence $7 D024901
650    _2
$a Escherichia coli $7 D004926
650    _2
$a lidé $7 D006801
650    12
$a pacienti hospitalizovaní $7 D007297
650    _2
$a mikrobiální testy citlivosti $7 D008826
650    _2
$a prevalence $7 D015995
650    _2
$a retrospektivní studie $7 D012189
650    12
$a poranění míchy $x komplikace $x farmakoterapie $x epidemiologie $7 D013119
650    _2
$a beta-laktamasy $7 D001618
655    _2
$a časopisecké články $7 D016428
700    1_
$a Paldus, Vít $u Department of Urology, Krajská Nemocnice Liberec, Husova 10, 46063, Liberec, Czech Republic $1 https://orcid.org/0000000211098336
700    1_
$a Fáčková, Daniela $u Department of Microbiology, Krajská Nemocnice Liberec, Liberec, Czech Republic
700    1_
$a Mečl, Jan $u Department of Urology, Krajská Nemocnice Liberec, Husova 10, 46063, Liberec, Czech Republic $1 https://orcid.org/0000000235090988
700    1_
$a Šrám, Jaroslav $u Traumatology and Orthopedics Center, Krajská Nemocnice Liberec, Liberec, Czech Republic $1 https://orcid.org/0000000218060998
773    0_
$w MED00008185 $t BMC infectious diseases $x 1471-2334 $g Roč. 22, č. 1 (2022), s. 239
856    41
$u https://pubmed.ncbi.nlm.nih.gov/35264096 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20220425 $b ABA008
991    __
$a 20220506130411 $b ABA008
999    __
$a ok $b bmc $g 1788753 $s 1161974
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2022 $b 22 $c 1 $d 239 $e 20220309 $i 1471-2334 $m BMC infectious diseases $n BMC Infect Dis $x MED00008185
LZP    __
$a Pubmed-20220425

Find record

Citation metrics

Archiving options