临床特征,抗菌素耐药性模式和Corynebacterium细菌病的结果:一项15年的回顾性研究
T-Touch Anawilkul1, Sarunyou Chusri2, Siripen Kanchanasuwan2
1Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand.
BMC infectious diseases
|November 27, 2025
概括
近一半的Corynebacterium血培养表明真正的感染,与增加的死亡率有关. 血液恶性瘤和中央静脉导管使用预测死亡率,而万科米辛仍然有效对抗抗性菌株,如C.striatum.
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:
- 科里尼菌种越来越多地被认为是病原体,而不仅仅是污染物.
- 它们的临床意义,耐药性模式和预后因素需要进一步定义.
- 了解真正的细菌病与污染对患者管理至关重要.
研究的目的:
- 为了描述Corynebacterium bacteremia的临床特征.
- 分析抗菌素耐药性概况并确定真正的细菌病预测因素.
- 确定与30天全因死亡率相关的因素.
主要方法:
- 一个15年的回顾性队列研究 (2009-2024) 的成年人与Corynebacterium阳性血液培养.
- 从2017年起使用MALDI-TOF MS进行物种识别.
- 采用了多变量物流和考克斯比例危险回归模型.
主要成果:
- 44%的病例是真正的细菌病,由血液恶性瘤,中央静脉导管使用,慢性病和高血压预测.
- 在真实细菌病 (43.8%) 和污染物 (23.3%) 中,30天死亡率更高.
- 最常见的物种C.striatum对青素和克林达米辛有很高的耐药性,但仍然对万科迈素敏感.
结论:
- 近一半的Corynebacterium血培养代表了具有显著死亡率的真实感染.
- 血液恶性瘤和中央静脉导管的使用是死亡率的关键预测因素.
- 范科米辛是一种可靠的经验疗法;物种识别和敏感性测试至关重要.
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