患有COVID-19的患者中的多种耐药性细菌:一项流行病学和临床研究
Gleyce Hellen de Almeida de Souza1, Alexandre Ribeiro de Oliveira1, Marcelo Dos Santos Barbosa1
1Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados - UFGD, Dourados, Mato Grosso do Sul, Brazil.
Journal of infection and public health
|June 4, 2023
概括
耐多药格拉姆阴性细菌 (MDR-GNB) 感染显著增加了巴西COVID-19患者的死亡率. 尽量减少侵入性设备和先前的抗微生物药物暴露对于在重症监护机构中获得更好的结果至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 二次多药耐药 (MDR) 格拉姆阴性细菌 (GNB) 感染对冠状病毒病 (COVID-19) 患者构成重大威胁.
- 关于巴西COVID-19患者中MDR-GNB发生率的流行病学数据有限.
研究的目的:
- 确定与COVID-19患者MDR-GNB获取相关的因素.
- 描述与这些患者不良结果相关的死亡率和临床特征.
主要方法:
- 一项涉及巴西280名重症监护病房患者的病例控制研究 (2020年3月至2021年12月).
- 分析了926个孤立的格拉姆阴性细菌 (GNB),其中504个被确定为MDR-GNB.
- 与MDR-GNB感染和没有感染的COVID-19患者之间的结局的比较.
主要成果:
- 在8.38%的COVID-19患者中发生了MDR-GNB感染.
- 与COVID-19-MDR-GNB感染相关的因素包括肥胖,心力衰竭,机械通风,尿导管和之前的β-lactam使用.
- 与对照组相比,患有MDR-GNB的COVID-19患者的死亡率 (68.6%) 显著高于对照组 (35.7%仅用于COVID-19).
- 尿导管使用,功能衰竭和特定培养来源 (气管内分泌物) 与死亡率有关.
结论:
- MDR-GNB感染在COVID-19患者中的病例死亡率大幅增加.
- 尽量减少侵入性设备的使用和先前的抗微生物药物暴露对于控制细菌传播至关重要.
- 减少MDR-GNB的干预措施对于改善重症患者的预后至关重要.
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