血流感染:老年患者的致病因子,抗生素耐药性和相关因素
Hoang-Van Quang1,2, Le-Thi Kim Nhung1, Pham-Thi Thanh Thuy2
1Department of Internal Medicine, Medical Faculty, Nguyen Tat Thanh University, Ho Chi Minh City, Viet Nam.
患有血液感染的老年患者的多药抗生素耐药性是一个越来越令人担忧的问题. 这项研究发现死亡率高,特别是来自抗生素耐药细菌的死亡率高,这突显出迫切需要有效干预措施.
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
- 老年医学 老年医学
背景情况:
- 在老年患者中,医院内血流感染 (BSI) 中,多药抗生素耐药性 (AMR) 的增加率.
- 人们越来越担心AMR对脆弱人群的临床和公共卫生影响.
研究的目的:
- 研究老年患者血液感染中的细菌抗生素耐药性模式.
- 确定与该患者队列死亡率相关的关键因素.
主要方法:
- 从2016年1月到2019年12月,对817名阳性血液培养的老年患者进行了回顾性研究.
- 分析常见的细菌分离物,抗生素易感性以及败血症休克和死亡率.
- 多变量分析以确定死亡率的重要预测因素.
主要成果:
- 扩展谱β-乳糖酶 (ESBL) 的阳性率为9.5%,在大肠杆菌 (48.9%) 中的高率.
- 常见的分离物包括大肠杆菌,斯坦诺托福蒙纳斯马尔托菲利亚和斯塔菲洛科克斯物种.
- 死亡率为28.9%,主要因素包括晚年,高SOFA分数,呼吸道感染,重症监护和败血症休克.
结论:
- 高死亡率仍然存在于患有BSI的老年患者中,特别是那些由抗生素耐药性病原体引起的患者.
- 针对性干预和抗微生物药物管理对于减轻AMR对这一群体的影响至关重要.
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