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关键COVID-19患者的细菌社区和医院获得的肺炎 - 一项前性单心队列研究

Lenka Doubravská^1,2, Miroslava Htoutou Sedláková^3,4, Kateřina Fišerová^3,4

¹Department of Anaesthesiology, Resuscitation and Intensive Care, University Hospital Olomouc, Zdravotniku 248/7, 779 00 Olomouc, Czech Republic.

Antibiotics (Basel, Switzerland)

|February 23, 2024

概括

细菌性肺炎显著增加了重症COVID-19患者的死亡率. 在社区和医院获得的肺炎 (CAP和HAP) 是常见的,特定的细菌罪祸首被确定. 诊断标记显示的准确性有限.

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
微生物学微生物学

背景情况:

在重症患者中,细菌性肺炎和COVID-19之间的相互作用需要进一步阐明.
细菌性肺炎,无论是社区获得的 (CAP) 还是医院获得的 (HAP),都可能使严重的COVID-19病例复杂化.

研究的目的:

为了确定COVID-19重病患者中CAP和HAP的发生率.
评估细菌性肺炎对这一群体死亡率的影响.
识别细菌病因和评估诊断工具,包括炎症生物标志物.

主要方法:

未来的观察性单心队列研究.
包括171名重症COVID-19患者入住重症监护室 (ICU).
从电子健康记录收集数据,包括生物标志物,微生物学和临床数据.

主要成果:

46%的患者发展了CAP,78%的患者发展了HAP.
与没有细菌性肺炎的患者相比,细菌性肺炎患者的死亡率 (38%为CAP,56%为HAP) 显著更高 (11%).
常见的CAP病原体包括Chlamydophila,Mycoplasma和多药耐药的肠杆菌;HAP病原体主要是肠杆菌和格兰阴性非发酵杆. 值得注意的是,Streptococcus pneumoniae没有出现.

结论:

细菌性肺炎是重症COVID-19患者死亡的一个重要因素.
传统的生物化学标记物对细菌性肺炎的诊断准确性不佳.
诊断需要临床评估,炎症标志物 (CAP的前素,HAP的IL-6) 和微生物学发现的结合.

关键词:

成年呼吸应急综合征 (ARDS) 是一个疾病.细菌的同时感染或超级感染.这是一种细菌性肺炎.在社区获得的肺炎 (CAP)危急的冠状病毒疾病19 (COVID-19)致病因子致病因子致病因子在医院获得的肺炎 (HAP)重症监护室 (ICU) 的重症监护室死亡率死亡率严重急性呼吸系统综合征冠状病毒-2 (SARS-CoV-2)

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