在COVID-19危急病患者中的细菌联合感染
Mateusz Bartoszewicz1, Edyta Wilczyk-Chrostek1, Sławomir Lech Czaban1
1Department of Anesthesiology and Intensive Care, Medical University of Bialystok, Bialystok, Poland.
细菌共感染在2019年冠状病毒病 (COVID-19) 的重症监护室 (ICU) 患者中很常见. 长时间的ICU住院和通风增加了感染风险,而Klebsiella pneumoniae是常见的病原体.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 微生物学 微生物学
背景情况:
- 患有2019年新冠肺炎 (COVID-19) 的重症监护室 (ICU) 患者面临更高的二次细菌感染风险.
- 常见的共感染包括呼吸器相关的肺炎 (VAP),血液感染 (BSI) 和导管相关的尿路感染 (CA-UTI).
研究的目的:
- 为了确定患病率,确定风险因素,并描述入住ICU的COVID-19患者的细菌共感染的谱.
- 将发现与现有文献和评论进行比较.
主要方法:
- 一个单一中心的回顾性队列研究分析了201名COVID-19患者的数据,这些患者被送往波兰比亚里斯托克的大学临床重症监护医院.
- 2020年3月至2021年7月期间收集的数据包括共感染流行率,危险因素和致病因子.
主要成果:
- 细菌共感染很普遍,影响了70%的研究的COVID-19重症监护室患者.
- 与呼吸机相关的肺炎 (VAP) 是最常见的 (47.5%的共感染),其次是BSI和CA-UTI.
- 长时间的机械呼吸 (平均13.3天) 和长时间的重症监护室停留 (平均15.3天) 是显著的风险因素.
- 肺炎菌和黄金葡萄球菌是主要的病原体. 产生扩展光谱β-乳糖酶的Klebsiella pneumoniae (ESBL) 经常被隔离 (>48h ICU入院).
结论:
- 细菌共感染是ICU中的COVID-19患者的一个重大问题.
- 有效的管理需要警监测,强有力的抗菌药物管理和严格的感染预防策略.
- 解决这些共同感染对于改善ICU环境中的患者结果至关重要.
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