【medical-news】CID：入院患者大肠杆菌泌尿源菌血症与致肾盂肾炎大肠杆菌系统性感染相关
发布于 2012-05-26 · 浏览 1098 · IP 山东山东
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Both Host and Pathogen Factors Predisposeto Escherichia coli Urinary-Source Bacteremia in Hospitalized Patients
22431806
http://cid.oxfordjournals.org/content/54/12/1692.abstract
Background.The urinary tract is the most common source forEscherichia coli bacteremia. Mortality from E. coli urinary-source bacteremiais higher than that from urinary tract infection. Predisposing factors forurinary-source E. coli bacteremia are poorlycharacterized.
Methods.In order to identify urinary-source bacteremiarisk factors, we conducted a 12-month prospective cohort study of adultinpatients with E. coli bacteriuria that were tested for bacteremia within ±1day of the bacteriuria. Patients with bacteremia werecompared with those without bacteremia. Bacterial isolates from urine werescreened for 16 putative virulence genes using high-throughput dot-blothybridization.
Results.Twenty-four of 156 subjects (15%) had E. colibacteremia. Bacteremic patients were more likely tohave benign prostatic hyperplasia (56% vs 19%; P = .04), a history ofurogenital surgery (63% vs 28%; P = .001), and presentation withhesitancy/retention (21% vs 4%; P = .002), fever (63% vs 38%; P = .02), andpyelonephritis (67% vs 41%; P = .02). The genes kpsMT (group II capsule) (17[71%] vs 62 [47%]; P = .03) and prf (P-fimbriae family) (13 [54%] vs 40 [30%];P = .02) were more frequent in the urinary strains from bacteremic patients.Symptoms of hesitancy/retention (odds ratio [OR], 7.8; 95% confidence interval[CI], 1.6–37), history of a urogenital procedure (OR, 5.4; 95% CI, 2–14.7), andpresence of kpsMT (OR, 2.9; 95% CI, 1–8.2) independently predicted bacteremia.
Conclusions.Bacteremia secondary to E. coli bacteriuria was frequent (15%) in those tested for it. Urinary stasis,surgical disruption of urogenital tissues, and a bacterial capsulecharacteristic contribute to systemic invasion by uropathogenic E. coli.
22431806
http://cid.oxfordjournals.org/content/54/12/1692.abstract
Background.The urinary tract is the most common source forEscherichia coli bacteremia. Mortality from E. coli urinary-source bacteremiais higher than that from urinary tract infection. Predisposing factors forurinary-source E. coli bacteremia are poorlycharacterized.
Methods.In order to identify urinary-source bacteremiarisk factors, we conducted a 12-month prospective cohort study of adultinpatients with E. coli bacteriuria that were tested for bacteremia within ±1day of the bacteriuria. Patients with bacteremia werecompared with those without bacteremia. Bacterial isolates from urine werescreened for 16 putative virulence genes using high-throughput dot-blothybridization.
Results.Twenty-four of 156 subjects (15%) had E. colibacteremia. Bacteremic patients were more likely tohave benign prostatic hyperplasia (56% vs 19%; P = .04), a history ofurogenital surgery (63% vs 28%; P = .001), and presentation withhesitancy/retention (21% vs 4%; P = .002), fever (63% vs 38%; P = .02), andpyelonephritis (67% vs 41%; P = .02). The genes kpsMT (group II capsule) (17[71%] vs 62 [47%]; P = .03) and prf (P-fimbriae family) (13 [54%] vs 40 [30%];P = .02) were more frequent in the urinary strains from bacteremic patients.Symptoms of hesitancy/retention (odds ratio [OR], 7.8; 95% confidence interval[CI], 1.6–37), history of a urogenital procedure (OR, 5.4; 95% CI, 2–14.7), andpresence of kpsMT (OR, 2.9; 95% CI, 1–8.2) independently predicted bacteremia.
Conclusions.Bacteremia secondary to E. coli bacteriuria was frequent (15%) in those tested for it. Urinary stasis,surgical disruption of urogenital tissues, and a bacterial capsulecharacteristic contribute to systemic invasion by uropathogenic E. coli.
最后编辑于 2012-05-26 · 浏览 1098
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