Pathogenic bacteria distribution,clinical features and risk factors of urinary tract infection in patients with isch-emic stroke
10.3969/j.issn.1006-9771.2024.10.008
- VernacularTitle:缺血性脑卒中患者并发尿路感染的病原菌分布、临床特点及危险因素
- Author:
Pei TIAN
1
;
Rongfu FAN
;
Hongyan WANG
;
Mingli PENG
Author Information
1. 中国康复研究中心北京博爱医院,药剂科,北京市 100068
- Keywords:
ischemic stroke;
urinary tract infection;
pathogen distribution;
clinical features;
risk factors
- From:
Chinese Journal of Rehabilitation Theory and Practice
2024;30(10):1179-1186
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the pathogenic bacteria distribution,clinical features and risk factors of urinary tract infection in patients with ischemic stroke. Methods A retrospective study was conducted on 634 patients with ischemic stroke in Beijing Bo'ai Hospital from Janu-ary,2020 to December,2023.They were divided into control group(n=551,without urinary tract infection)and observation group(n=83,with urinary tract infection)according to whether they developed urinary tract infec-tion.The incidence of urinary tract infection,the distribution of pathogenic bacteria and the resistance of main pathogenic bacteria to different antibacterial drugs were analyzed.The clinical characteristics of the two groups were compared and analyzed.The independent risk factors of urinary tract infection in patients with ischemic stroke were analyzed with multivariate Logistic regression. Results A total of 83 cases of 634 patients with ischemic stroke developed urinary tract infection,and incidence was 13.09%.A total of 127 strains of pathogenic bacteria were isolated from the urine samples of the observation group,of which Gram-negative bacteria accounted for 62.99%(80/127),Gram-positive bacteria accounted for 20.47%(26/127)and strains of fungi accounted for 16.54%(21/127).The main Gram-negative pathogens were Escherichia coli and Klebsiella pneumoniae,which were high resistant to second-generation and third-generation cephalosporins,co-trimoxazole,and levofloxacin;moderately resistant to carbapenems,β-lactamase inhibitor compound preparation and aminoglycosides,etc.;and highly sensitive to tigecycline and polymyxin,etc.The main Gram-positive pathogens were Enterococcus faecalis and Enterococcus faecalis,which were a high resistant to erythromycin and gentamicin,and highly sensitive to linezolid,daptomycin,teicoplanin and vancomycin.The pathogenic fungi detected were not obviously resistant to common antifungal drugs.The proportion of female,di-abetes,indwelling catheter and neurogenic bladder were significantly higher in the observation group than in the control group(χ2>5.043,P<0.05).The female,diabetes,indwelling catheter and neurogenic bladder were inde-pendent risk factors for urinary tract infection in patients with ischemic stroke(P<0.05). Conclusion The pathogenic bacteria of patients with ischemic stroke with urinary tract infection are mainly Gram-nega-tive bacteria,followed by Gram-positive bacteria and fungi.The Gram-negative bacteria showed multiple drug re-sistance.Meanwhile,female,diabetes,indentured catheter and neurogenic bladder are the independent risk fac-tors for urinary tract infection.
