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Войти в исследования Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2025
Comparison of urinary tract-related and catheter-related bloodstream infections in long-term and acute care wards: A retrospective cohort study.
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Kumagai Kohei, Inose Ryo, Kimura Asako, Muraki Yuichi
Аннотация
BACKGROUND: The characteristics of bloodstream infections in patients admitted to long-term care wards remain unclear. This study examined differences in nosocomial-onset urinary tract-related bloodstream infections (UTRBSIs) and catheter-related bloodstream infections (CRBSIs) between patients admitted to long-term and acute care wards.
METHODS: This retrospective cohort study was conducted at a mixed-care hospital with long-term and acute care wards from April 2015 to March 2024. Patient backgrounds, causative pathogens, antibiotic resistance, and treatment patterns were compared between the two groups.
RESULTS: Among the 252 patients, 108 (42.9 %) were diagnosed with UTRBSIs and 87 (34.5 %) with CRBSIs. In UTRBSIs, the long-term care group had significantly longer hospitalization (721 vs. 16 days, P < 0.001), more frequent use of indwelling urinary catheters (76.7 % vs. 28.6 %, P < 0.001), and higher isolation rates of extended-spectrum β-lactamase-producing Enterobacterales (41.1 % vs. 8.6 %, P < 0.001). Piperacillin/tazobactam and meropenem were significantly more frequently used empirically in the long-term care group. In CRBSIs, the isolation rates of main causative pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) (9.5 % vs. 6.7 %, P = 0.707) and methicillin-resistant coagulase-negative Staphylococcus spp. (40.5 % vs. 48.9 %, P = 0.519), showed no significant differences between the two groups despite differences in patient backgrounds. Anti-MRSA agents were rarely used empirically in both groups (19.0 % vs. 15.6 %, P = 0.779).
CONCLUSIONS: Patients admitted to long-term care wards may require empirical therapy for UTRBSIs targeting drug-resistant Enterobacterales, while for CRBSIs, empirical use of anti-MRSA agents may be considered, similar to patients admitted to acute care wards.
METHODS: This retrospective cohort study was conducted at a mixed-care hospital with long-term and acute care wards from April 2015 to March 2024. Patient backgrounds, causative pathogens, antibiotic resistance, and treatment patterns were compared between the two groups.
RESULTS: Among the 252 patients, 108 (42.9 %) were diagnosed with UTRBSIs and 87 (34.5 %) with CRBSIs. In UTRBSIs, the long-term care group had significantly longer hospitalization (721 vs. 16 days, P < 0.001), more frequent use of indwelling urinary catheters (76.7 % vs. 28.6 %, P < 0.001), and higher isolation rates of extended-spectrum β-lactamase-producing Enterobacterales (41.1 % vs. 8.6 %, P < 0.001). Piperacillin/tazobactam and meropenem were significantly more frequently used empirically in the long-term care group. In CRBSIs, the isolation rates of main causative pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) (9.5 % vs. 6.7 %, P = 0.707) and methicillin-resistant coagulase-negative Staphylococcus spp. (40.5 % vs. 48.9 %, P = 0.519), showed no significant differences between the two groups despite differences in patient backgrounds. Anti-MRSA agents were rarely used empirically in both groups (19.0 % vs. 15.6 %, P = 0.779).
CONCLUSIONS: Patients admitted to long-term care wards may require empirical therapy for UTRBSIs targeting drug-resistant Enterobacterales, while for CRBSIs, empirical use of anti-MRSA agents may be considered, similar to patients admitted to acute care wards.