与社区开始的卡巴耐药肠道细菌感染相比,医院发生的死亡率增加

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Angelique E Boutzoukas^1,2, Natalie Mackow³, Abhigya Giri⁴

¹Department of Pediatrics, Duke University, Durham, NC, USA.

The Journal of antimicrobial chemotherapy

|September 5, 2024

概括

医院发病的耐卡巴胺的肠细菌 (CRE) 血流感染 (BSI) 对患者的结局的影响比社区发病的CRE BSI更大. 加强监测和预防感染对于降低这些感染的死亡率至关重要.

科学领域:

传染性疾病传染性疾病
公共卫生公共卫生
临床微生物学临床微生物学

背景情况:

耐卡巴胺肠道细菌 (CRE) 感染构成重大威胁,在COVID-19大流行期间报告的入院病例显著增加.
了解HO和社区发病 (CO) CRE血流感染 (BSI) 之间的患者结果差异对于有效管理至关重要.

研究的目的:

为了比较患者在医院发病 (HO) 和社区发病 (CO) 之间的患者结局,抗卡巴因的肠细菌 (CRE) 血流感染 (BSI).
为公共卫生战略提供信息,以监测和预防CRE的感染.

主要方法:

一项前性研究 (CRACKLE-2) 涉及10个国家的56家医院的891名CRE BSI患者.
根据CDC的指导方针,感染被分类为CO或HO.
两组之间比较了临床特征和患者的结果,包括结果排名的可取性 (DOOR) 和30天死亡率.

主要成果:

医院发病的CRE BSI (65%的病例) 与社区发病的CRE BSI相比,与明显更差的结果有关.
患有HO CRE BSI的患者年轻,但病情更严重.
对于HO CRE BSI (33%) 和CO CRE BSI (21%),30天死亡率明显高.

结论:

医院发病的CRE血流感染对患者的治疗结果的影响不成比例,比社区发病的感染更大.
霍克雷感染的增加需要加强监测和强有力的感染预防策略,以减轻死亡率.

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