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溺水相关肺炎的微生物学特征:系统性审查和元分析
Vladimir L Cousin1, Laure F Pittet2
1Intensive Care Unit, Department of Pediatric, Gynecology and Obstetrics, University Hospital of Geneva, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1206, Geneva, Switzerland. Vladimir.Cousin@hcuge.ch.
溺水相关性肺炎 (DAP) 影响了39%的患者,通常是由像Aeromonas sp.这样的阴性细菌引起的. 氨基氨酸可能对近三分之一的这些病原体无效.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 溺水相关肺炎 (DAP) 是溺水患者经常出现的并发症,可能会增加死亡率.
- 了解致病微生物对于优化实证抗微生物治疗至关重要.
研究的目的:
- 为了确定DAP的综合流行率.
- 为了确定涉及DAP的微生物.
- 评估DAP对患者结局的影响.
主要方法:
- 2000年1月至2023年7月期间发表的研究的系统审查和元分析.
- 包括6项回顾性队列研究,涉及688名患者.
主要成果:
- DAP的综合流行率为39%,淡水 (44%) 和海水 (42%) 的溺水率相似.
- 格拉姆阴性细菌 (57%) 占主导地位,尤其是Aeromonas sp. (12%),仅在淡水溺水中发现.
- 近30%的分离微生物对阿莫西西林-克拉夫兰酸耐药.
结论:
- DAP通常是由阴性细菌引起的,特别是Aeromonas sp. 在淡水溺水事件中.
- 经验性抗菌药物治疗应针对这些病原体,因为在很大一部分病例中,阿莫西西林-克拉夫兰酸可能不足.
- DAP对患者死亡率的影响仍然不确定.
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