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菌病的趋势:探索风险因素,重点是先前暴露于抗生素

Erik Sörstedt^1,2, Gustaf Ahlbeck^1,3, Ulrika Snygg-Martin^1,2,4

¹Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.

|October 26, 2024

概括

由Enterococcus faecium (EfmB) 引起的肠球菌性细菌病例正在增加,可能与增加的piperacillin/tazobactam使用有关. 这种转变需要谨慎的抗生素策略来对抗耐药细菌.

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
抗微生物耐药性抗微生物耐药性

背景情况:

肠球菌性细菌病 (EB) 是一个日益严重的全球健康问题.
菌 (Enterococcus faecium) (EfmB) 对像皮佩拉西林/塔扎巴克坦 (pip/taz) 这样的常见抗生素表现出耐药性,与菌 (Enterococcus faecalis) 不同.
流行病学的转变表明,EfmB作为医院病原体的增加正在增加.

研究的目的:

调查与pip/taz使用相关的EfmB发病率的趋势.
为了确定EfmB的风险因素,特别是先前的抗生素暴露.
分析患者人口统计和EfmB与E. faecalis bacteremia (EfsB) 的结果.

主要方法:

萨尔格伦斯卡大学医院360名EB患者的医疗记录的回顾性审查.
随着时间的推移 (2015-2021年) 分析了EfmB案件的比例.
统计分析以确定EfmB的独立风险因素,包括抗生素病史.

主要成果:

EfmB病例的比例从2015年的41%上升到2021年的51%.
在医院获得的感染,先前暴露于pip/taz和卡巴因被确定为EfmB的独立风险因素.
在EfmB和EfsB组之间没有观察到死亡率的显著差异.

结论:

越来越多的EfmB比例是一个令人担忧的趋势,可能与增加的pip/taz利用率有关.
谨慎的抗生素管理对于缓解抗生素耐药性肠球菌的传播至关重要.
对EfmB的驱动因素和最佳治疗策略的进一步研究是有必要的.

关键词:

肠球菌 (Enterococcus faecium) 是一个有毒的菌株.抗生素耐药性抗生素耐药性肠球菌细菌病的细菌病.皮佩拉西林 / 塔扎巴克坦

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