在左心室辅助器件接受者中,鼻腔感染的流行病学和危险因素
Simone Mornese Pinna1, Silvia Corcione1,2, Elena Cavallone3
1Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Turin, Italy.
Life (Basel, Switzerland)
|February 24, 2024
概括
在使用左心室辅助器件 (LVAD) 的患者中,鼻腔感染 (NIs) 是常见的,而更长时间的重症监护室停留增加了风险. 格兰阴性细菌,包括多药耐药菌株,是常见的病因,但感染患者和未感染患者的死亡率没有差异.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 医疗器械 医疗器械
背景情况:
- 左心室辅助器件 (LVAD) 对末期心力衰竭至关重要,但与感染等并发症有关.
- 鼻腔感染 (NIs) 是LVAD接受者面临的重大挑战,影响患者的治疗结果.
- 了解NI的流行病学和风险因素对于改善这种人群的护理至关重要.
研究的目的:
- 在接受连续流动LVADs的成年患者中调查医院感染 (NIs) 的流行病学和风险因素.
- 确定LVAD相关感染中多药耐药 (MDR) 细菌的流行率.
- 分析NI对住院死亡率的影响.
主要方法:
- 2010年1月至2017年12月期间接受连续流动LVAD植入的成年患者的回顾性队列研究.
- 数据收集包括患者人口统计,LVAD细节,感染类型,致病因子和结果.
- 统计分析确定了NI和MDR感染的风险因素,包括重症监护室 (ICU) 住院时间和INTERMACS类.
主要成果:
- 50%的患者 (32/64) 经历了至少一个NI,总共发生了46次感染事件.
- 与VAD相关的感染发生在22名患者中,主要是由阴性菌根 (GNB) 引起的.
- 长时间的ICU入院是NI的重要风险因素 (或1.224).
- 在50%的感染中发现了MDR菌株,其中KPC-KP和MDR PA是常见的.
- 对于MDR NIs来说,INTERMACS类和机械通风持续时间是风险因素.
- 住院死亡率为6.3%,感染患者和未感染患者之间没有显著差异.
结论:
- 在LVAD患者中,病床感染的发生率与ICU停留时间有关.
- 含有高比例的MDR菌株的グラム陰性菌根是LVAD植入後NI的主要原因.
- 尽管MDR感染率高,但在感染和未感染LVAD患者之间没有观察到在医院死亡率的显著差异.
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