动脉腿部 - 细菌模式,抗微生物耐药性和临床特征,回顾性单中心队列,2012-2021年
Jonas Salm1, Tanja Böhme1, Elias Noory1
1Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
PloS one
|August 11, 2023
概括
在患有外周动脉疾病 (PAD) 的患者中,严重的伤口感染很常见. 金黄色葡萄球菌是最常见的病原体,高克林达米辛耐药性表明经验性治疗可能会失败.
科学领域:
- 血管外科 血管外科
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 患有外周动脉疾病 (PAD) 的患者严重的伤口感染是一个重大的临床挑战,往往导致肢体和危及生命的并发症.
- 有限证据表明,与PAD相关的感染腿部的特定微生物特征和抗菌素耐药性模式是有限的.
研究的目的:
- 在患有PAD的患者中调查感染动脉腿部的微生物景观.
- 确定关键病原体的抗微生物耐药性 (AMR) 模式,重点关注金黄色葡萄球菌.
- 在这个患者队列中识别与黄金葡萄球菌感染相关的危险因素.
主要方法:
- 对1,142名患有PAD (Rutherford类别5或6) 和受感染的腿部的患者进行了内血管再血管化 (2012-2021) 的回顾性分析.
- 细菌分离物的鉴定和抗微生物敏感性测试.
- 后勤回归分析,以确定黄金葡萄球菌相关感染的风险因素.
主要成果:
- 黄金葡萄球菌是最常见的病原体 (18.6%),其次是菌 (9.1%) 和S. epidermidis (7.8%).
- 在S. aureus分离物中观察到显著的克林达米辛耐药性 (11.0%),而氧素耐药性低 (1.5%).
- 大肠杆菌表现出高水平的多药耐药性 (MDR),包括对阿莫西西林/克拉夫兰酸 (36.8%) 的耐药性.
- 末期病是S. aureus鉴定的一个独立风险因素 (p = .042).
结论:
- 黄金葡萄球菌是PAD患者中动脉腿的主要病原体,特别是末期病患者.
- 黄金菌中高克林达米辛耐药性需要仔细考虑经验性抗生素治疗.
- 大肠杆菌中MDR的高患病率凸显了治疗这些感染的复杂挑战.
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