多种耐药性格拉姆阴性细菌的直肠殖民化以及随后在血液病患者中的细菌病
Antonio Gallardo-Pizarro1, Carlos Lopera1, Olivier Peyrony2
1Infectious Disease Department, Hospital Clinic of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.
概括
在血液病患者中对多药耐药格拉姆阴性细菌 (MDR-GNB) 的常规监测可以很早地发现殖民,通常是在血液感染 (BSI) 之前. 这有助于预测和潜在地防止严重的MDR-GNBBSI.
科学领域:
- 传染性疾病 传染性疾病
- 血液学 瘤学 癌症学
- 临床微生物学 临床微生物学
背景情况:
- 耐多药格拉姆阴性细菌 (MDR-GNB) 对免疫功能低下的患者,特别是患有血液性恶性瘤的患者构成重大威胁.
- 早期检测MDR-GNB殖民对于预防后续感染至关重要,例如血液感染 (BSI).
研究的目的:
- 通过直肠抽样,确定血液病患者中MDR-GNB殖民的流行率.
- 调查MDR-GNB殖民化与BSI发展之间的关联.
主要方法:
- 从2020年1月到2022年9月,每周对血液病患者进行MDR-GNB的直肠拭子查.
- 使用欧洲临床微生物学和传染病学会2022年标准对MDR-GNB (3GCephRE,CRE,DTR P. aeruginosa,抗卡巴胺A. baumannii) 的回顾性分析.
主要成果:
- 16.6%的直肠拭子 (27.5%的患者) 呈MDR-GNB.阳性.
- 大肠杆菌,Klebsiella肺炎综合体和P. aeruginosa是最常见的MDR-GNB.
- 与非殖民患者 (12.0%) 相比,殖民患者的BSI发病率明显高 (38.5%).
结论:
- 常规的每周监测有效地识别了血液病患者的MDR-GNB殖民.
- 早期识别殖民可能会在MDR-GNB BSIs之前,突出显示监控的价值.
- 需要通过调整分析进行进一步的研究,以确认BSI殖民的独立预测价值.
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