Clinical characteristics and risk factors of healthcare-associated urinary tract infection due to vancomycin-resistant Enterococcus
10.12138/j.issn.1671-9638.20252028
- VernacularTitle:医院获得性耐万古霉素肠球菌尿路感染临床特征及其危险因素
- Author:
Weisha WANG
1
;
Biyi FENG
;
Xiaohong WU
;
Yunhu ZHAO
;
Suling LIU
Author Information
1. 南方医科大学附属广东省人民医院/广东省医学科学院检验科,广东 广州 510080
- Publication Type:Journal Article
- Keywords:
vancomycin-resistant Enterococcus;
urinary tract infection;
clinical characteristics;
risk factor;
anti-microbial susceptibility;
healthcare-associated
- From:
Chinese Journal of Infection Control
2025;24(8):1042-1048
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical characteristics and risk factors of healthcare-associated urinary tract infection(HA-UTI)due to vancomycin-resistant Enterococcus(VRE),and provide basis for clinical prevention and control.Methods Patients with VRE HA-UTI in a tertiary first-class hospital in Guangdong Province from January 2021 to October 2023 were selected as the VRE group.A 1∶2 case-control study method was conducted to select pa-tients with vancomycin-sensitive Enterococcus(VSE)UTI as the VSE group.Clinical characteristics of two groups of patients were compared and analyzed.Risk factors for VRE HA-UTI were analyzed using univariate regression and logistic multivariate regression.Results A total of 32 patients in the VRE group and 64 patients in the VSE group were included in the analysis.In VRE group,most patients were female(68.75％),aged≥60 years(71.88％),and from intensive care unit(ICU,56.25％).The main detected pathogen was vancomycin-resistant Enterococcus faecium(VREfm,96.87％).The proportion of clinical symptoms such as fever and lumbago as well as the levels of procalcitonin(PCT)and C-reactive protein(CRP)in patients in the VRE group were all higher than those in the VSE group(all P＜0.05).Logistic regression analysis results showed that concomitant pulmonary infection(OR=6.890,95％CI:1.098-43.218,P=0.039),history of hypertension(OR=4.240,95％CJ:1.084-16.581,P=0.038),and cephalosporin antibiotic exposure before infection(OR=4.642,95％CI:1.270-16.967,P=0.020)were independent risk factors for VRE HA-UTI.There were 32 and 64 strains of Enterococcus detected from VRE group and VSE group,respectively.VRE had higher resistance rates to ciprofloxacin,amoxicillin,ampicillin,peni-cillin G,tetracycline,high concentration gentamicin,and levofloxacin than VSE(all P＜0.05).Conclusion Pa-tients with VRE HA-UTI often have multiple underlying diseases and poor nutritional status,and are highly resis-tant to multiple antimicrobial agents.Clinical attention should be focused on patients with concomitant pulmonary infection,history of hypertension,and exposure to cephalosporin antibiotics.
