流行病学和癌症患者胆汁源血流感染病例复发的风险因素
Ignacio Grafia1, Mariana Chumbita2, Elia Seguí1
1Medical Oncology Department, Hospital Clínic-IDIBAPS , Barcelona, Spain.
Microbiology spectrum
|August 23, 2023
概括
癌症患者的胆汁源血流感染 (BSI) 经常是由多药耐药的阴性菌引起的,导致高死亡率. 一个新的分数有助于预测复发性BSI,有助于预防策略.
科学领域:
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
- 内部医学 内部医学
背景情况:
- 胆汁源血流感染 (BSI) 对瘤患者构成重大威胁.
- 了解这些感染的特征和危险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 描述癌症患者胆道源BSI的特征和结果.
- 为了确定与反复发生的BSI事件相关的风险因素.
- 开发一次性胆汁源BSI的预测得分.
主要方法:
- 从2008年至2019年在瘤患者中的胆汁源BSI的前性收集和回顾性分析.
- 后勤回归分析以确定反复出现的BSI的独立风险因素.
- 使用已识别的风险因素开发和验证预测得分.
主要成果:
- 在291名患者中记录了400个胆汁源的BSI,其中包括大肠杆菌和克莱布西拉菌. 作为常见的病原体.
- 耐多药格拉姆阴性细菌 (MDR-GNB) 导致了21.5%的发作,随着时间的推移,发病率不断增加.
- 73名患者出现了复发性BSI;独立的风险因素包括先前的抗生素治疗,胆道假体,先前的胆道感染入院和MDR-GNB BSI.
- 一个预测得分显示高准确性 (AUC 0.819) 复发的BSIs.
- 在23.8%的病例中观察到不适当的经验性抗生素治疗 (IEAT),30天死亡率为19.5%.
结论:
- 癌症患者的胆汁源BSI主要是由GNB引起的,其MDR率高且不断上升,IEAT频繁,死亡率显著.
- 复发性BSI发作很常见,与治疗延迟和不良结果有关.
- 经过验证的预测得分可以帮助识别患有复发性BSI高风险的患者,从而使有针对性的预防策略能够减少发病率和死亡率.
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