严重和复杂的软组织感染:一个单中心病例系列
Zeynep Ture1, Gamze Kalin Unuvar1, Aliye Esmaoglu2
1Department of Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
Journal of wound care
|August 12, 2023
概括
复杂的皮肤和软组织感染 (cSSTIs) 具有显著的死亡风险,特别是败血症和低血症. 早期识别风险因素和局部耐药性模式对于有效治疗至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 卫生经济学 卫生经济学
背景情况:
- 复杂的皮肤和软组织感染 (cSSTIs) 是一个重大的临床挑战.
- 了解cSSTI的人口,临床和经济方面对于优化患者护理至关重要.
- 多种耐药生物的高发病率使治疗策略复杂化.
研究的目的:
- 描述患有cSSTI的患者的人口和临床概况.
- 确定与cSSTI结果相关的实验室发现和风险因素.
- 评估cSSTI的经济负担,包括治疗成本和死亡率.
主要方法:
- 在2017年1月至2019年12月期间被诊断患有cSSTI的患者的回顾性分析.
- 评估人口统计数据,临床表现,实验室结果和治疗干预措施.
- 统计分析以确定影响死亡率和治疗成本的因素.
主要成果:
- 该研究包括24名患者,58%为女性,平均年龄为53岁. 糖尿病是最常见的并发症 (54%).
- 败血症 (75%) 和高临床风险指标对死性筋膜炎 (LRINEC) 评分 (70%) 在入院时普遍存在. 在50%的病例中发现了多抗药性格拉姆阴性细菌.
- 死亡率为29%,死亡率为29%. 非生存的显著预测因素包括混乱,格兰氏阴性感染,低血和重症监护室 (ICU) 的入院. 低血是死亡的一个独立风险因素 (p=0.048). 与幸存者相比,非幸存者的治疗费用 (9453美元) 和幸存者的治疗费用 (1536美元) 显著更高.
结论:
- 对cSSTI的实证抗菌和外科治疗策略应考虑局部耐药性模式.
- 败血症,高LRINEC分数和低血量是cSSTI患者死亡率的关键预测因素.
- 解决低血和早期识别败血症对于改善结果和减少cSSTI的经济负担至关重要.
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