Povećana učestalost urinarnih infekcija izazvanih rodom Enterococcus kod pacijenata COVID-19 bolnice Kliničkog Centra Vojvodine

Gordana Smieško; Marija  Baroš Brkljača; Pavle Z Banović

doi:10.5937/pomc19-37033

Gordana Smieško 1- Katedra za mikrobiologiju sa parazitologijom i imunologijom, Medicinski fakultet Novi Sad, Univerzitet u Novom Sadu, 21000 Novi Sad
Marija Baroš Brkljača Institut za javno zdravlje Vojvodine, 21000 Novi Sad
Pavle Z Banović 1.Pasterov zavod Novi Sad 2.Medicinski fakultet Novi Sad, Univerzitet u Novom Sadu

DOI: https://doi.org/10.5937/pomc19-37033

Ključne reči: urin, COVID19, Vojvodina, Enterococcus, Escherichia coli

Sažetak

Cilj: Ispitivanje učestalosti izolata različitih uropatogena kod pacijenata COVID19 bolnice ,,Mišeluk’’ u poređenju sa pacijentima iz ne-COVID19 zone Kliničkog Centra Vojvodine (KCV).

Metode: Za potrebe ovog istraživanja sakupljene su informacije o izolatima iz urina upućenih iz COVID19 bolnice i ne-COVID19 zona KCV u tromesečnom periodu, pri čemu su uzorci iz ne-COVID19 zone KCV služile kao kontrola.

Rezultati: Od 449 nalaza pacijenata iz COVID19 bolnice, najčešći nalaz su pripadnici roda Enterococcus, (216/449; 48,10%), koji su u najvećem broju slučajeva uzrokovali IUT kod žena (127/216; 58,79%). Drugi po učestalosti uzročnik IUT u COVID19 bolnici je Klebsiella pneumoniae (85/449; 18,93%). Od 913 nalaza pacijenata iz ne-COVID19 klinika KCV, najčešći uzročnik IUT je Escherichia coli (249/913; 27,27%), i to dominantno kod žena (199/249; 79,91%, (χ2 (1) = 49,042; p < 0,00001)). Drugi po učestalosti uzročnih IUT su pripadnici roda Enterococcus, (216/913; 23,65%), bez značajne razlike u distribuciji među polovima (χ2 (1) = 0,0833; p = 0,847).

Zaključak:Najčešći uzročnici IUT u COVID19 bolnici KCV su pripadnici roda Enterococcus i Klebsiella pneumoniae sa gotovo ravnomernom raspodelom među polovima. Uočena je statistični značajna razlika u učestalosti različitih izazivača IUT kod pacijenata COVID19 bolnice naspram ne-COVID19 klinika KCV. Ovi rezultati mogu biti značajni za određivanje empirijske terapije kod pacijenata COVID19 bolnice KCV, kao i pri planiranju procedura za redukciju intrahospitalih infekcija.

Reference

Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269–84.

Woldemariam HK, Geleta DA, Tulu KD, Aber NA, Legese MH, Fenta GM, et al. Common uropathogens and their antibiotic susceptibility pattern among diabetic patients. BMC Infect Dis. 2019 Jan 10;19(1):43.

Stefaniuk E, Suchocka U, Bosacka K, Hryniewicz W. Etiology and antibiotic susceptibility of bacterial pathogens responsible for community-acquired urinary tract infections in Poland. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol. 2016 Aug;35(8):1363–9.

Rizwan M, Akhtar M, Najmi AK, Singh K. Escherichia coli and Klebsiella pneumoniae Sensitivity/Resistance Pattern Towards Antimicrobial Agents in Primary and Simple Urinary Tract Infection Patients Visiting University Hospital of Jamia Hamdard New Delhi. Drug Res. 2018 Jul;68(7):415–20.

Behzadi P, Behzadi E, Yazdanbod H, Aghapour R, Akbari Cheshmeh M, Salehian Omran D. A survey on urinary tract infections associated with the three most common uropathogenic bacteria. Maedica. 2010 Apr;5(2):111–5.

Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis Off Publ Infect Dis Soc Am. 2011 Mar 1;52(5):e103-120.

Karaba SM, Jones G, Helsel T, Smith LL, Avery R, Dzintars K, et al. Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study. Open Forum Infect Dis. 2021 Jan;8(1):ofaa578.

Garcia-Vidal C, Sanjuan G, Moreno-García E, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2021 Jan;27(1):83–8.

Bardi T, Pintado V, Gomez-Rojo M, Escudero-Sanchez R, Azzam Lopez A, Diez-Remesal Y, et al. Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol. 2021 Mar;40(3):495–502.

Zuglian G, Ripamonti D, Tebaldi A, Cuntrò M, Riva I, Farina C, et al. The changing pattern of bacterial and fungal respiratory isolates in patients with and without COVID-19 admitted to intensive care unit. BMC Infect Dis. 2022 Feb 23;22(1):185.

DeVoe C, Segal MR, Wang L, Stanley K, Madera S, Fan J, et al. Increased rates of secondary bacterial infections, including Enterococcus bacteremia, in patients hospitalized with coronavirus disease 2019 (COVID-19). Infect Control Hosp Epidemiol. 2021 Sep 6;1–8.