Analysis of epidemiological characteristics and risk factors of catheter-associated urinary tract infections in patients with perineal and/or hip burns

Zheng Xinxin; Kong Ling'ai; Lyu Rang; Xu Caijuan

doi:10.3760/cma.j.cn501225-20231027-00138

Volume 40 Issue 3

Mar. 2024

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2024 > 40(3): 289-295

Zheng XX,Kong LA,Lyu R,et al.Analysis of epidemiological characteristics and risk factors of catheter-associated urinary tract infections in patients with perineal and/or hip burns[J].Chin J Burns Wounds,2024,40(3):289-295.DOI: 10.3760/cma.j.cn501225-20231027-00138.

Citation:

PDF( 968 KB)

Analysis of epidemiological characteristics and risk factors of catheter-associated urinary tract infections in patients with perineal and/or hip burns

doi: 10.3760/cma.j.cn501225-20231027-00138

1.
Nursing Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
2.
Gastrointestinal Surgery Medical Center, Weifang People's Hospital, Weifang 261041, China
3.
School of Nursing, Huzhou University, Huzhou 313000, China

More Information

Corresponding author: Xu Caijuan, Email: xucaijuan@zju.edu.cn
Received Date: 2023-10-27

Abstract

Abstract

Objective To explore the epidemiological characteristics and risk factors of catheter-associated urinary tract infections in patients with perineal and/or hip burns. Methods This study was a retrospective case series study. From January 2018 to December 2022, 260 patients with perineal and/or hip burns and urinary catheters indwelling who met the inclusion criteria were admitted to the Department of Burns and Wound Repair of the Second Affiliated Hospital of Zhejiang University School of Medicine, including 192 males and 68 females, aged 20-93 years. The total incidence of catheter-associated urinary tract infections in patients with perineal and/or hip burns, the detection of pathogenic bacteria, and the resistance of major Gram-negative and Gram-positive bacteria to commonly used antimicrobial drugs in clinic were recorded. According to whether catheter-associated urinary tract infection occurred or not, the patients were divided into infection group (43 cases) and non-infection group (217 cases). The basic conditions including gender, age, total burn area, depth of perineal burn, depth of hip burn, and burn site on admission, complications of diabetes mellitus, inhalation injury, and hypoproteinaemia, invasive operations including tracheotomy and non-perineal/hip debridement/skin transplantation surgery, duration of catheter retention, number of urethral catheterization, and bladder irrigation of patients between the two groups were compared, and the independent risk factors influencing the occurrence of catheter-associated urinary tract infections in patients with perineal and/or hip burns were screened. Results The total incidence of catheter-associated urinary tract infections in patients with perineal and/or hip burns in this study was 16.5% (43/260). The pathogens detected were predominantly Gram-negative, followed by fungi; the main Gram-negative bacterium was Klebsiella pneumoniae, and the main Gram-positive bacterium was Enterococcus faecalis. The resistance rates of Klebsiella pneumoniae to amoxicillin/clavulanic acid, amitraz, amikacin, ciprofloxacin, ceftriaxone, and levofloxacin were higher than 70.0%, the resistance rates of Klebsiella pneumoniae to cefoxitin, cefoperazone/sulbactam, cefepime, meropenem, imipenem, and piperacillin/tazobactam ranged from 56.3% to 68.8%, and the resistance rates of Klebsiella pneumoniae to ceftazidime and tigecycline were lower than 50.0%. The resistance rates of Enterococcus faecalis to ciprofloxacin and penicillin were both 85.7%, the resistance rates of Enterococcus faecalis to erythromycin, clindamycin, moxifloxacin, and tetracycline ranged from 14.3% to 57.1%, and the resistance rates of Enterococcus faecalis to linezolid, tigecycline, and vancomycin were all 0. The differences were statistically significant between the two groups in terms of gender, status of complication of hypoproteinaemia, depth of perineal burn, status of non-perineal/hip debridement/skin transplantation surgery, status of bladder irrigation, number of urethral catheterization, and duration of catheter retention of patients (with χ ² values of 7.80, 4.85, 10.68, 9.11, and 16.48, respectively, and Z values of -4.88 and -5.42, respectively, P<0.05). There were no statistically significant differences in the age, total burn area, complications of diabetes mellitus and inhalation injury, burn site, depth of hip burns, and status of tracheotomy of patients between the two groups ( P>0.05). Multifactorial logistic regression analysis showed that gender, deep partial-thickness perineal burns, non-perineal/hip debridement/skin transplantation surgery, bladder irrigation, and duration of catheter retention were the independent risk factors for catheter-associated urinary tract infections in patients with perineal and/or hip burns (with odds ratios of 2.86, 2.63, 2.79, 2.34, and 1.04, respectively, with 95% confidence intervals of 1.21-6.73, 1.03-6.71, 1.03-7.59, 1.05-5.22, and 1.02-1.06, respectively, P<0.05). Conclusions The incidence of catheter-associated urinary tract infections is high in patients with perineal and/or hip burns, with Klebsiella pneumoniae as the predominant pathogenic bacteria having a high resistance rate to commonly used antimicrobial drugs in clinic. Gender, deep partial-thickness perineal burns, non-perineal/hip debridement/skin transplantation surgery, bladder irrigation, and duration of catheter retention are the independent risk factors for catheter-associated urinary tract infections in patients with perineal and/or hip burns.
- Burns,
- Perineum,
- Buttocks,
- Infection,
- Risk factors,
- Catheter-associated urinary tract infection

FullText(HTML)

References(20)

References

[1]	DerkenneC,RonchiL,PrunetB.Management of burns[J].N Engl J Med,2019,381(12):1188.DOI: 10.1056/NEJMc1909342.
[2]	MichielsenDP,LafaireC.Management of genital burns: a review[J].Int J Urol,2010,17(9):755-758.DOI: 10.1111/j.1442-2042.2010.02605.x.
[3]	BordesJ,Le FlochR,BourdaisL,et al.Perineal burn care: French working group recommendations[J].Burns,2014,40(4):655-663.DOI: 10.1016/j.burns.2013.09.007.
[4]	ClemensMS,JanakJC,RizzoJA,et al.Burns to the genitalia, perineum, and buttocks increase the risk of death among U.S. service members sustaining combat-related burns in Iraq and Afghanistan[J].Burns,2017,43(5):1120-1128.DOI: 10.1016/j.burns.2017.01.018.
[5]	HarpoleBG,WibbenmeyerLA,EricksonBA.Genital burns in the national burn repository: incidence, etiology, and impact on morbidity and mortality[J].Urology,2014,83(2):298-302.DOI: 10.1016/j.urology.2013.10.039.
[6]	KranzJ,SchmidtS,WagenlehnerF,et al.Catheter-associated urinary tract infections in adult patients[J].Dtsch Arztebl Int,2020,117(6):83-88.DOI: 10.3238/arztebl.2020.0083.
[7]	DeeterL,SeatonM,CarrougherGJ,et al.Hospital-acquired complications alter quality of life in adult burn survivors: report from a burn model system[J].Burns,2019,45(1):42-47.DOI: 10.1016/j.burns.2018.10.010.
[8]	卫生部办公厅导尿管相关尿路感染预防与控制技术指南(试行) 2010-11-29 2023-05-13 http://www.gov.cn/gzdt/2010-12/14/content_1765450.htm 卫生部办公厅.导尿管相关尿路感染预防与控制技术指南(试行)[EB/OL].(2010-11-29)[2023-05-13].http://www.gov.cn/gzdt/2010-12/14/content_1765450.htm.
[9]	张可祥,李风.烧伤患者泌尿系医院感染病原体调查与临床研究[J].重庆医学,2009,38(10):1225-1226.DOI: 10.3969/j.issn.1671-8348.2009.10.037.
[10]	向军,郇京宁.烧伤患者抗碳青霉烯类抗生素肺炎克雷伯菌感染的再认识及抗菌治疗策略[J].中华烧伤杂志,2018,34(11):790-795.DOI: 10.3760/cma.j.issn.1009-2587.2018.11.014.
[11]	LanP,JiangY,ZhouJ,et al.A global perspective on the convergence of hypervirulence and carbapenem resistance in Klebsiella pneumoniae[J].J Glob Antimicrob Resist,2021,25:26-34.DOI: 10.1016/j.jgar.2021.02.020.
[12]	曾凌,徐珍,戴小华,等.烧伤患者耐碳青霉烯类肺炎克雷伯菌感染的环境追踪研究[J].中国感染控制杂志,2022,21(12):1179-1184.DOI: 10.12138/j.issn.1671-9638.20223116.
[13]	张娇珍,林秀慧,张新平,等.尿路感染患者尿液标本分离肠球菌的临床分布、耐药性及毒力特征[J].中华医院感染学杂志,2023,33(5):713-717.DOI: 10.11816/cn.ni.2023-221016.
[14]	全国细菌耐药监测网.2020年全国细菌耐药监测报告[J].中华检验医学杂志,2022,45(2):122-136.DOI: 10.3760/cma.j.cn114452-20211118-00721.
[15]	ZamparEF,AnamiEHT,KerbauyG,et al.Infectious complications in adult burn patients and antimicrobial resistance pattern of microorganisms isolated[J].Ann Burns Fire Disasters,2017,30(4):281-285.
[16]	刘琰,王际壮.烧伤应激反应及其调控策略[J].中华烧伤杂志,2021,37(2):126-130.DOI: 10.3760/cma.j.cn501120-20201125-00499.
[17]	VinaikR,BarayanD,ShahrokhiS,et al.Management and prevention of drug resistant infections in burn patients[J].Expert Rev Anti Infect Ther,2019,17(8):607-619.DOI: 10.1080/14787210.2019.1648208.
[18]	韩春茂,王新刚.《国际烧伤协会烧伤救治实践指南》2018版解读[J].中华烧伤杂志,2021,37(2):196-200.DOI: 10.3760/cma.j.cn501120-20191129-00447.
[19]	赵旭,赵璐,严向明,等.细菌生物膜的形成与导管相关性尿路感染的关系[J].中华医院感染学杂志,2017,27(18):4154-4158.DOI: 10.11816/cn.ni.2017-172466.
[20]	鲁虹言,王淑君,李方容,等.大面积烧伤患者卧翻身床尿袋放置方法的改进[J].护理学杂志,2016,31(10):66-67.DOI: 10.3870/j.issn.1001-4152.2016.10.066.

Relative Articles

[1]	Ma Qimin, Tang Wenbin, Li Xiaojian, Chang Fei, Yin Xi, Chen Zhaohong, Wu Guohua, Xia Chengde, Li Xiaoliang, Wang Deyun, Chu Zhigang, Zhang Yi, Wang Lei, Wu Choulang, Tong Yalin, Cui Pei, Guo Guanghua, Zhu Zhihao, Huang Shengyu, Chang Liu, Liu Rui, Liu Yongji, Wang Yusong, Liu Xiaobin, Shen Tuo, Zhu Feng. Multicenter retrospect analysis of early clinical features and analysis of risk factors on prognosis of elderly patients with severe burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(3): 249-257. doi: 10.3760/cma.j.cn501225-20230808-00042
[2]	Jiang Nanhong, Xie Weiguo, Wang Deyun, Chu Zhigang, Xi Maomao, Zhou Jinxiu, Li Feng. Analysis of risk factors for atrial fibrillation in adult patients with critically severe burns after the first surgery[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(9): 857-865. doi: 10.3760/cma.j.cn501225-20240329-00111
[3]	Pan Xuanliang, Zhu Zhikang, Shen Tao, Jin Fang, Wang Xingang, Yin Jun, Han Chunmao. Epidemiological characteristics and risk factors of sepsis development and death in patients with extremely severe burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(6): 558-564. doi: 10.3760/cma.j.cn501225-20220806-00336
[4]	Chen Nuo, Xi Maomao, Ruan Qiongfang, Chu Zhigang, Zhang Wei, Zhang Jinli, Xie Weiguo. Risk factors of early myocardial injury and the impact of early myocardial injury on prognosis of patients with extensive burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(5): 417-423. doi: 10.3760/cma.j.cn501225-20230308-00074
[5]	Tang Wenbin, Chen Bin, Ou Shali, Li Xinying, Xiao Kui, Wang Sisi, Li Xiaojian. Analysis of the risk factors of persistent inflammation-immunosuppression-catabolism syndrome in patients with extensive burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(4): 350-355. doi: 10.3760/cma.j.cn501225-20220214-00028
[6]	Li Yanguang, Chang Shuailei, Xie Jiangfan, Ye Xiangyang, Wang Lei, Li Yancang, Li Yun, Li Xiaoliang. Analysis of clinical characteristics and risk factors of death in critical burn patients complicated with invasive fungal infection[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(7): 618-624. doi: 10.3760/cma.j.cn501225-20230415-00127
[7]	Zheng Xinxin, Shi Ping, Feng Huali, Lyu Rang, Xu Caijuan, Chen Ziwen. Current status and research advances on catheter-associated urinary tract infection in burn patients[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(6): 581-585. doi: 10.3760/cma.j.cn501225-20220904-00378
[8]	Chen Bin, Tang Wenbin, Li Xiaojian, Ou Shali, Li Xinying, Xiao Kui, Wang Sisi. Analysis of the clinical characteristics and risk factors of postoperative atrial fibrillation in patients with critical burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2022, 38(5): 408-414. doi: 10.3760/cma.j.cn501225-20220214-00026
[9]	Hu Min, Chen Xiaojuan, Ren Linjie, Huang Jianqiong, Xu Xuewen. A cross-sectional investigation on the current status and influencing factors of kinesiophobia in adult burn patients[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(6): 575-581. doi: 10.3760/cma.j.cn501120-20200618-00313
[10]	Zhang Yin, Ma Zhenzhu, Wu Beiwen, Dou Yi, Zhang Qin, Yang Luyu, Chen Erzhen. Establishment of an early risk prediction model for bloodstream infection and analysis of its predictive value in patients with extremely severe burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(6): 530-537. doi: 10.3760/cma.j.cn501120-20210114-00021
[11]	Zhang Wei, Zhang Junfeng, Wang Mi, Xia Chengde, Wang Lijie, Liu Baohui, Di Haiping, Xue Jidong, Lou Jihe. Occurrence of deep venous thrombosis in adult burn patients and its risk factors[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(1): 54-57. doi: 10.3760/cma.j.issn.1009-2587.2020.01.010
[12]	Ren Haitao, Han Chunmao, Zhang Jingjing, Hu Hang, Zhang Rong. Epidemiological investigation of burn patients with Klebsiella pneumoniae infection and the analysis of risk factors for sepsis in them[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2019, 35(6): 456-458. doi: 10.3760/cma.j.issn.1009-2587.2019.06.011
[13]	Wu Jing, Zhang Qin, Liu Jian, Tang Jiajun, Zheng Jiexin. Influencing factors and clinical significance of severe hypocalcemia in patients with extremely severe burns in early stage[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2018, 34(4): 203-207. doi: 10.3760/cma.j.issn.1009-2587.2018.04.003
[15]	Liu Xiaolong, Su Fuzeng, Zha Tianjian, Liu Lihua, Wang Zhizhong, Nuerlan null. Analysis on the risk factors of diabetic foot ulcer in diabetic patients of Uyghur nationality and Han nationality in the Xinjiang Uygur Autonomous Region[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2017, 33(8): 486-490. doi: 10.3760/cma.j.issn.1009-2587.2017.08.006
[16]	Gao Fengying, Xi Yaofeng, Zheng Mingxia, Qiao Fen. Prevalence of deep venous thrombosis in burn patients and its influencing factors[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2016, 32(3): 176-180. doi: 10.3760/cma.j.issn.1009-2587.2016.03.010
[17]	Fang Li, Wang Fan, Sun Kedai, Zhou Tao, Gong Yali, Peng Yizhi. Analysis on the prevalence of central venous catheter-related infection in burn patients and its risk factors[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2016, 32(4): 243-248. doi: 10.3760/cma.j.issn.1009-2587.2016.04.013
[18]	SHI Miao-miao, ZHAO Dong-mei, WANG Qiang, CHENG Jun, MA Tai, XU Yuan-hong, XU Qing-lian, LI Jia-bin. Analysis of drug resistance and risk factors of Enterobacteriaceae in burn units[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2010, 26(3): 199-201. doi: 10.3760/cma.j.issn.1009-2587.2010.03.009
[19]	LI Yong-lin, XIAO Hai-tao, QI Qiang, ZHOU Zhao-ping, OKA Hiroaki, MORIGUCHI Takahaki. Clinical efficacy of artery pedorator-based flap in the repair of gluteal-sacral pressure sores[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2007, 23(1): 32-35.

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(1) / Tables(4)

Get Citation

PDF

XML

Article Metrics

Article views (208) PDF downloads(35)

Analysis of epidemiological characteristics and risk factors of catheter-associated urinary tract infections in patients with perineal and/or hip burns

doi: 10.3760/cma.j.cn501225-20231027-00138

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Analysis of epidemiological characteristics and risk factors of catheter-associated urinary tract infections in patients with perineal and/or hip burns

doi: 10.3760/cma.j.cn501225-20231027-00138

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content