血流感染Pseudomonas aeruginosa后的复发和死亡率:基于人口的队列研究
Felicity Edwards1,2,3, Michael Waller4, Kevin B Laupland5,6
1Queensland University of Technology (QUT), Brisbane, QLD, Australia. felicity.edwards@qut.edu.au.
概括
血流感染 (BSI) 具有很高的死亡率和复发率. 识别恶性瘤和年龄等危险因素可以帮助临床医生量身定制经验治疗以获得更好的患者结果.
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:
- 血流感染 (BSI) 存在重大临床挑战,其特点是复发率和死亡率高.
- 了解导致这些不良结果的因素对于优化经验治疗策略至关重要.
研究的目的:
- 为了确定与Pseudomonas aeruginosa BSI.患者的死亡率和复发相关的基线因素.
- 为临床决策提供信息,并改善对P. aeruginosa BSI.的经验性治疗选择.
主要方法:
- 从2000年到2019年,澳大利亚昆士兰州进行了一项基于人口的队列研究,分析了来自5742名患有P. aeruginosa BSI.的患者的数据.
- 使用多项式和二进制逻辑回归模型,分别确定复发和死亡的相对风险比率 (RRR) 和几率比率 (OR).
主要成果:
- 总的来说,20.5%的患者在30天内死亡,21.3%在30天到三年之间死亡,4.6%的患者出现了复发. 恶性病,转移性癌症和无并发症糖尿病与复发风险增加有关.
- 患有恶性瘤,充血性心力衰竭,痴呆症,脏疾病,肺部疾病和晚年患者的死亡风险较高. 社区发病的感染和泌尿生殖源与减少复发和死亡率有关.
- 在复发性感染中观察到抗菌素对塞夫塔齐 (10.7%) 和西普洛素 (10.1%) 的耐药性,尽管整体敏感性基本保持稳定.
结论:
- Pseudomonas aeruginosa BSI 与大量的死亡率和临床上显著的复发率有关.
- 鉴定的风险因素和结果预测因素可以帮助临床医生做出更明智的经验性治疗决策,治疗P. aeruginosa BSI.
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