难以治疗的耐药格拉姆阴性血流感染 - - 超级细菌时代的开始 - - 一项前性观察性研究
Naveenraj P1, Deepak Kumar1, Durga Shankar Meena1
1Department of General Medicine and Infectious Diseases, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Indian journal of medical microbiology
|June 25, 2023
概括
难以治疗的耐药性 (DTR) 细菌感染是印度日益严重的问题. 这些DTR感染与显著更高的死亡率有关,突显出迫切需要更好的抗生素管理.
科学领域:
- 传染性疾病 传染性疾病
- 抗微生物耐药性 抗微生物耐药性
- 公共卫生 公共卫生
背景情况:
- 耐卡巴尼姆的グラム阴性细菌感染对全球健康构成重大威胁.
- 印度面临着治疗这些感染的有效抗生素的严重短缺.
- 难以治疗的耐药性 (DTR) 格拉姆阴性感染研究不足,但使临床环境复杂化.
研究的目的:
- 在住院患者中确定DTR细菌血流感染 (GNBSI) 的发病率.
- 分析与DTR GNBSI相关的结果,特别是30天死亡率.
- 在印度背景下确定DTR GNBSI的风险因素和常见致病因子.
主要方法:
- 进行了一项单一中心前性观察研究.
- 包括年龄≥18岁的住院患者,患有格兰阴性细菌血流感染 (GNBSI).
- 分析了DTR感染和30天死亡率的发病率,不包括污染物和单个股骨部位培养.
主要成果:
- 在240个GNBSI事件中,DTR GNBSI发生在37.9%的事件中.
- 在医院获得的感染,ICU入院和机械通风是DTR GNBSI的独立风险因素.
- 克莱布西拉肺炎和Acinetobacter baumannii是最常见的DTR分离物. DTR GNBSI显示,调整后相对死亡风险显著更高 (aRR 3.9).
结论:
- 在印度,DTR阴性菌感染越来越令人担忧,需要进行多中心研究.
- DTR GNBSI与死亡率大幅增加有关.
- 极其需要加强抗生素管理实践,以对抗DTR感染.
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