Epidemiology of pathogens and antimicrobial resistance of nosocomial urinary tract infections in patients with spinal cord injuries in China: A systematic review and meta-analysis

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2129154 · Published: July 1, 2023

Spinal Cord Injury Immunology Healthcare

Simple Explanation

This study examines urinary tract infections (UTIs) in patients with spinal cord injuries (SCI) in China, focusing on the types of bacteria causing these infections and their resistance to antibiotics. The researchers analyzed data from multiple studies conducted in China to identify common pathogens and their antibiotic resistance patterns before and after 2012. The findings reveal that Gram-negative bacteria, particularly E. coli, are the primary cause of UTIs in SCI patients, and there have been changes in antibiotic resistance profiles over time, suggesting that antibiotic control measures may be having a positive effect.

Study Duration

ranging from September 1996 to June 2018

Participants

7271 bacterial species

Evidence Level

Systematic review and meta-analysis

Key Findings

1
UTIs in patients with SCI in China are mainly caused by gram-negative bacteria.
2
E. coli was the most common pathogenic bacteria, followed by Klebsiella pneumoniae.
3
A remarkable modification in resistance profiles of pathogen distribution before 2012 and after 2012 was observed.

Research Summary

The study aimed to characterize the distribution of pathogens in UTI patients with spinal cord injuries (SCI) and their resistance to antibiotics. The meta-analysis of 33 studies revealed that UTIs in SCI patients in China are mainly caused by gram-negative bacteria, with E. coli being the most common pathogen. Changes in antibiotic resistance profiles were observed between the periods before and after 2012, suggesting that reasonable control of antibiotic use has a positive effect on resistance profiles.

Practical Implications

Infection Control Strategies

Hospitals and healthcare facilities should implement and reinforce strict infection control practices to minimize the spread of resistant bacteria, especially among vulnerable SCI patients.

Antibiotic Stewardship Programs

The findings support the implementation and continuation of antibiotic stewardship programs to promote the rational use of antibiotics and reduce the development of antibiotic resistance.

Surveillance and Monitoring

Continuous surveillance of pathogen distribution and resistance patterns is essential to inform empirical antibiotic therapy guidelines and adapt infection control strategies effectively.

Study Limitations

1
Study includes 33 studies combining data from 7271 episodes of bacteria from 9 provinces or municipalities.
2
High heterogeneity between studies was observed.
3
The study did not evaluate the distinction between nosocomial and non-nosocomial infections.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury