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在高风险的希腊患者中,与多药耐药生物体的直肠殖民和血液感染的风险
Polyxeni Karakosta1, Georgios Meletis2, Elisavet Kousouli3
1Laboratory of Clinical Microbiology, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
多种耐药生物体 (MDROs) 殖民直肠显著增加了血液感染 (BSI) 的风险. 这一发现强调了考虑患者殖民状态对于有效的经验治疗策略的重要性.
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
- 流行病学 流行病学
背景情况:
- 复杂耐药生物体 (MDRO) 的直肠殖民与更高的感染风险有关.
- 希腊关于MDRO殖民和随后的血液感染 (BSI) 的数据有限,尽管国家MDRO率很高.
研究的目的:
- 评估在希腊医院中特定的MDROs通过直肠殖民后发生血流感染 (BSI) 的风险.
- 量化直肠殖民和随后的BSI之间的关联,由耐卡巴胺的肠杆菌 (CRE),耐卡巴胺的Acinetobacter baumannii (CRAB),耐卡巴胺的Pseudomonas aeruginosa (CRPA) 和耐万科胺的肠球菌 (VRE) 引起.
主要方法:
- 在2019年至2022年期间,在三家希腊医院进行了一项前性研究.
- 这项研究涉及4,370名住院患者,评估了各种MDROs的直肠殖民率.
- 随后的BSI被监测,以确定与先前殖民相关的风险.
主要成果:
- 观察到高的直肠殖民率:CRE的31.1%,CRAB的30.1%,CRPA的5.8%,VRE的28.4%.
- 患有直肠殖民的患者显著增加了来自同一MDRO物种的后续BSI的风险 (例如,CRE:RR 5.2,CRAB:RR 2.7,CRPA:RR 9.6,VRE:RR 2.5).
结论:
- MDROs的直肠殖民是导致相同生物体引起的BSI发展的重要危险因素.
- 临床医生应将MDRO携带状态纳入他们选择实证抗菌药物治疗的决策过程.
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