Appraising epidemiology data and antimicrobial resistance of urinary tract infections in critically ill adult patients: a 7-year retrospective study in a referral Brazilian hospital
São Paulo med. j
; 141(6): e20210933, 2023. tab, graf
Article
en En
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LILACS-Express
| LILACS
| ID: biblio-1442183
Biblioteca responsable:
BR1.1
ABSTRACT
ABSTRACT BACKGROUND:
Urinary tract infections (UTI) are highly preventable and have significant clinical and financial impact on the patient and the health care system.OBJECTIVE:
To investigate UTIs in critically ill adult patients and the relationship of antimicrobial consumption and multidrug-resistant isolate. DESIGN ANDSETTING:
A cohort study performed in a Brazilian tertiary-care university hospital in the city of Uberlandia (MG), located at the Federal University of Uberlandia, southeast region of the country.METHODS:
We analyzed a cohort of 363 patients with first episode of UTIs from the adult intensive care unit (ICU), from January 2012 to December 2018. The daily doses of antimicrobial administered were calculated.RESULTS:
The incidence rate of UTI was 7.2/1000 patient days, with 3.5/1000 patient-days of bacteriuria, and 2.1/1000 patient-days of candiduria. Of 373 microorganisms identified, 69 (18.4%) were Gram-positive cocci, 190 (50.9%) Gram-negative bacilli, and 114 yeasts (30.7%). Escherichia coli and Candida spp. were the most common. Patients with candiduria had higher comorbidity score (Charlson Comorbidity Index ≥ 3), longer length of stay (P = 0.0066), higher mortality (P = < 0.0001) severe sepsis, septic shock, and were immunocompromised when compared with patients with bacteriuria. We observed correlation between antibiotics consumption and multidrug-resistant (MDR) microorganisms.CONCLUSION:
The UTIs incidence was high and was mainly caused by Gram-negative bacteria that were resistant to common antibiotics. We observed increase in the consumption of broad-spectrum antibiotics in ICU correlating with MDR microorganisms. In general, ICU-acquired candiduria may be associated with critical illness and poor prognosis.
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
País/Región como asunto:
America do sul
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Brasil
Idioma:
En
Revista:
São Paulo med. j
Asunto de la revista:
Cirurgia Geral
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Cincia
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Ginecologia
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MEDICINA
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Medicina Interna
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Obstetr¡cia
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Pediatria
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Sa£de Mental
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Sa£de P£blica
Año:
2023
Tipo del documento:
Article
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Project document
País de afiliación:
Brasil
Pais de publicación:
Brasil