血流感染 (BSI):来自印度的多中心数据,预测了患有格兰阴性细菌 (GNB) 血流感染 (BSI) 患者的死亡率
Nitin Bansal1, Kalpesh Suresh Sukhwani2, Veeren Ganta3
1Infectious Diseases, Rajiv Gandhi Cancer Institute, New Delhi, India.
Infectious diseases (London, England)
|January 13, 2025
概括
这项研究确定了Gram-Negative Bacilli血流感染中死亡率的关键预测因素. 在Pseudomonas aeruginosa和Acinetobacter baumannii中,卡巴因耐药性显著影响了患者的存活率.
科学领域:
- 传染性疾病 传染性疾病
- 临界护理医学 临界护理医学
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 阴性细菌 (GNB) 血流感染 (BSI) 构成重大威胁,卡巴胺耐药性 (CR) 成为一个主要问题.
- 了解死亡率的预测因素和CR的影响对于有效的患者管理和公共卫生战略至关重要.
研究的目的:
- 为了确定GNB BSI患者死亡率的预测因素.
- 估计特定 GNB 病原体中可归因于碳烯抗性的死亡率.
主要方法:
- 从2023年1月到2024年9月,在印度的3个三级护理中心进行了前性队列研究.
- 纳入标准:患有单微生物GNB BSI的患者. 主要结局:第30天的原始死亡率.
- 数据分析包括组间比较和多变量逻辑回归,以确定死亡率的独立预测因素.
主要成果:
- 在604名患者中,有140人 (23.2%) 在第30天死亡.
- 更高的顺序性器官衰竭评估 (SOFA) 评分,医院获得的BSI和CR在肠杆菌 (大肠杆菌,肺炎肺炎,宝曼尼菌) 和Pseudomonas aeruginosa的DTR (耐药性) 与增加的死亡率有关.
- 死亡率的独立预测因素是较高的SOFA得分,DTR-PA和CRAB.
结论:
- 虽然肠杆菌中的CR不是这一队列中死亡率的主要因素,但DTR-PA和CRAB是显著的独立预测因素.
- 在大肠杆菌和肺炎中,CR的可归因死亡率分别为7.32%和8.43%,而P. aeruginosa的DTR为52.4%.
相关概念视频
Factors Affecting the Risk of Infection
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
Clinical Significance of Antibiotic Resistance
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Bacterial Meningitis I: Introduction
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...


