Acinetobacter baumanniiとCandida aurisの有病率は,機械呼吸器を使用している患者で
Anthony D Harris1, Lisa Pineles1, J Kristie Johnson1
1University of Maryland School of Medicine, Baltimore.
JAMA
|October 12, 2023
まとめ
Acinetobacter baumanniiとCandida aurisは メリーランド州で機械呼吸器を使用している患者で,特に長期ケア施設ではよく見られます. これらの発見は,高リスク集団における標的化された監視と予防の必要性を強調しています.
科学分野:
- 感染症
- 公衆衛生の監視
- 抗菌剤に対する耐性
背景:
- 米国におけるAcinetobacter baumanniiとCandida aurisの流行に関する州全体のデータは限られている.
- 脆弱な患者集団におけるこれらの新興病原体の現在の負担はほとんど不明です.
研究 の 目的:
- メリーランド州内の機械呼吸器を必要とする患者のAcinetobacter baumanniiとCandida aurisの流行を決定する.
- 急性ケア病院と長期ケア施設の間の病原体の流行を比較する.
主な方法:
- メリーランド州51の医療施設で州全体の横断点の有病率調査が行われました.
- Acinetobacter baumanniiとCandida aurisのために470人の機械呼吸器を施した患者から監視培養物を採取した.
- Acinetobacter baumanniiに対する抗生物質感受性検査を行い,Candida aurisの検出にはポリメラーゼ連鎖反応を用いた.
主要な成果:
- Acinetobacter baumanniiの流行率は30. 7%で,単離物の59. 5%がカルバペネム耐性 (CRAB) であった.
- 陽性の症例の29%が新たに報告された.
- 長期ケア施設の患者は,急性ケア病院の患者と比較して,A. baumannii,CRAB,およびC. aurisのコロニー化率が著しく高かった.
結論:
- メリーランド州では 機械呼吸器を用いる患者でAcinetobacter baumanniiとCandida aurisが多く見られ, 長期ケア施設ではより高い割合です.
- 長期介護施設は 新しく発生する病原菌に 高いリスクがある場所です
- 標的を絞った監視と予防戦略は,これらの施設が耐性生物の拡散を緩和するために不可欠です.
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