Carbapenem-resistant urinary tract infection in patients with nephrolithiasis

Yakhyaev E.K., Yarovoy S.K., Dutov S.V., Tokhtiev Z.T., Kochetkov V.A., Martov A.G.

1) Medical and Biological Unit for Research and Education, Federal State Budgetary Institution «A.I. Burnazyan Federal Medical Biophysical Center» of FMBA of Russia, Moscow, Russia; 2) Lomonosov Moscow State University Medical Research and Educational Center, Moscow, Russia; 3) Federal State Budgetary Institution «Central Clinical Hospital of Civil Aviation», Moscow, Russia; 4) Research and Education Unit, Federal State Budgetary Educational Institution of Higher Education «ROSBIOTECH», Moscow, Russia; 5) State Budgetary Healthcare Institution «City Clinical Hospital No.31 named after Academician G.M. Savelyeva», Moscow, Russia; 6) N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Moscow, Russia; 7) State Budgetary Institution «City Clinical Hospital named after D.D. Pletnev», Moscow, Russia

Introduction. Carbapenems belong to reserve antibiotics; however, the frequency of carbapenem-resistant bacterial strains is increasing in hospitals. Resistance of nosocomial Gram-negative strains to carbapenems is a significant problem with a tendency to progress, necessitating close attention to it.
Objective. Analysis of the prevalence of carbapenem-resistant flora in a urology clinic, identifying the most significant factors associated with the resistance of pathogens to medications.
Material and methods. A single-center retrospective study was conducted analyzing 1,720 urine culture results from patients with nephrolithiasis managed at a tertiary care institution in Moscow.
Results. Acquired carbapenem resistance to at least one carbapenem was detected in 5.4% of patients. Carbapenem-resistant Klebsiella pneumoniae (70% of all carbapenem-resistant isolates) and Pseudomonas aeruginosa (13%) were the most frequently identified species. Male sex and age >50 years were identified as significant risk factors. A logistic regression model was constructed to quantify the contribution of major risk factors, demonstrating an area under the receiver operating characteristic curve (ROC-AUC) of 0.88.
Conclusion. The relatively high prevalence of carbapenem-resistant Gram-negative urinary tract infection among patients hospitalized for urological management of nephrolithiasis necessitates further research to identify optimal therapeutic strategies and prevent postoperative infectious complications caused by these pathogens. Moreover, the prevalence rate of carbapenem-resistant bacteria (5.4%) carries important implications for antimicrobial stewardship and pharmaceutical resource allocation in urological inpatient settings.

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About the Authors

Corresponding Author: E.K. Yakhyaev – Ph.D. student at the Department of Urology and Andrology, Medical and Biological Unit for Research and Education, Federal State Budgetary Institution «A.I. Burnazyan Federal Medical Biophysical Center» of FMBA of Russia, Moscow, Russia; Urologist at the Urologic Department of the State Budgetary Healthcare Institution «City Clinical Hospital No.31 named after Academician G.M. Savelyeva», Moscow, Russia, e-mail: elvinyakhyaev@mail.ru

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