Epidemiology of pathogens and antimicrobial resistance of nosocomial urinary tract infections in patients with spinal cord injuries in China: A systematic review and meta-analysis.
J Spinal Cord Med
; 46(4): 632-648, 2023 07.
Article
em En
| MEDLINE
| ID: mdl-36622339
ABSTRACT
CONTEXT Despite a high urinary tract infection (UTI) rate in spinal cord injured patents in China, there is limited evidence on the epidemiological character of that. OBJECTIVE:
The purpose of our article was to characterize the distribution of pathogens of UTI patients with spinal cord injuries (SCI) and the resistance profile of pathogens.METHODS:
A literature search of six electronic databases was carried out to identify the incidence, pathogen distribution, and drug resistance of UTI after SCI based on our inclusion and exclusion criteria. Meta-analysis was carried out using R 4.0.2 software; a subgroup analysis was performed by the year 2012.RESULTS:
We screened 1110 eligible studies, 33 were included in our final review. A total of 7271 bacterial species were included in our studies; 6092 were gram-negative (81.13% [76.83-85.11]) and 1003 were gram-positive (14.89% [11.70-18.38]). Before 2012, E. coli (45.43%) was the predominant isolated pathogen, followed by Klebsiella (7.49%) and Enterococcus (6.01%). After 2012, E. coli (50.23%) was the main pathogen, followed by Klebsiella (12.47%) and Proteus (6.88%). E. coli was more likely to be resistant to Levofloxacin, Amikacin, sulfonamides, 4th-generation cephalosporins and Nitrofurantoin before 2012 (81.8% vs. 62.9%, 32.0% vs. 7.6%, 81.3% vs. 61.6%, 81.8% vs. 24.1%, 33.5% vs. 5.1%), whereas E. coli was more frequently resistant to Inhibitor-resistant ß-lactamas after 2012 (56.3% vs. 34.0%). K. pneumoniae was more likely to be resistant to Aztreonam, Amikacin before 2012 (80.0% vs. 39.8%, 48.1% vs. 19.0%). P. aeruginosa presented a high resistance to Levofloxacin, Inhibitor-resistant ß-lactamas after 2012 (61.8% vs. 35.6%, 59.1% vs. 5.7%).CONCLUSIONS:
UTI in patients with SCI in China were mainly caused by gram-negative bacteria. We observed a remarkable modification in resistance profiles of pathogen distribution before 2012 and after 2012, which suggests reasonable control of the use of antibiotics has a positive effectiveness on resistance profiles.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismos da Medula Espinal
/
Infecções Urinárias
/
Infecção Hospitalar
Tipo de estudo:
Prognostic_studies
/
Screening_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
J Spinal Cord Med
Assunto da revista:
NEUROLOGIA
/
REABILITACAO
Ano de publicação:
2023
Tipo de documento:
Article