感染的长期风险在与抗微生物耐药病原体定居的患者中:全人口队列研究
Christina Blagojevic1, Kevin A Brown2,3,4, Christina Diong2
1Internal Medicine Residency Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Open forum infectious diseases
|December 20, 2024
概括
抗生素耐药性病原体的殖民化显著增加了感染风险,特别是当在医院检测到时. 早期发现殖民是感染控制和抗生素选择的关键.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 抗微生物耐药 (AMR) 病原体构成了全球重大健康挑战.
- 抗抗菌病原体的殖民是感染的前体,但相关的感染风险尚未完全理解.
- 对于公共卫生战略来说,研究AMR殖民化和随后感染之间的联系至关重要.
研究的目的:
- 为了确定在殖民检测后感染同一个AMR生物体的风险.
- 检查年龄,性别和医疗保健等因素如何影响这种风险.
主要方法:
- 在加拿大安大略省进行了回顾性,全人口的队列研究 (5年期间).
- 对具有特定AMR病原体定居的个体的卫生行政数据的分析.
- 纳入标准:抗甲基西林的黄金葡萄球菌,抗万科胺的肠球菌,产生ESBL的肠球菌,产生卡巴酶的肠球菌.
主要成果:
- 在69998名AMR定居者中,有15.6%的个体在平均57天内感染.
- 根据生物体的感染率有所不同:MRSA (18.3%),VRE (2.8%),ESBL-Enterobacterales (21.5%),CPE (20.3%).
- 与社区环境相比,医院检测到的殖民化与更高的后续感染风险有关.
结论:
- 在大多数AMR病原体的殖民化后观察到高感染率.
- 强调AMR殖民检测对于感染控制的重要性.
- 强调需要根据殖民状态进行知情的经验性抗生素选择.
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