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土耳其一家大学医院的医院内洋葱伯克霍尔德菌感染:一项为期五年的监测。

Nosocomial Burkholderia cepacia infections in a Turkish university hospital: a five-year surveillance.

作者信息

Dizbay Murat, Tunccan Ozlem Guzel, Sezer Busra Ergut, Aktas Firdevs, Arman Dilek

机构信息

Department of Infectious Diseases and Clinical Microbiology, Gazi University School of Medicine, Ankara, Turkey.

出版信息

J Infect Dev Ctries. 2009 May 1;3(4):273-7. doi: 10.3855/jidc.124.

Abstract

BACKGROUND

Burkholderia cepacia has the potential to cause fatal infections in ICUs, and multidrug resistance makes them a serious threat in hospital settings. The aim of this study was to evaluate the epidemiology of B. cepacia infections in our hospital.

METHODOLOGY

The incidence, clinical characteristics, antimicrobial susceptibility, and outcomes of nosocomial B. cepacia infections during a five-year period were retrospectively analysed according to the infection control committee records.

RESULTS

A total of 39 cases with nosocomial B. cepacia infection were included in the study. B. cepacia was identified from 0.7% of the nosocomial isolates. Its incidence was 0.26 per 1,000 admissions with 53.8% crude mortality rate. The most frequent nosocomial B. cepacia infection was pneumonia (58.9%), followed by bloodstream infections (25.6%), surgical site infections (7.6%), urinary tract infections, (5.1%), and skin-soft tissue infections (2.5%). Nosocomial B. cepacia infections were most commonly observed in intensive care units (61.5%). The most active antimicrobial agents were piperacillin-tazobactam, cefoperazone-sulbactam, and carbapenems.

CONCLUSIONS

The incidence of nosocomial B. cepacia infections was rare in our hospital, and no outbreak was detected during the study period. However, infections caused by B. cepacia should be taken into consideration because of their high mortality due to multidrug resistance in ICU settings.

摘要

背景

洋葱伯克霍尔德菌有可能在重症监护病房引发致命感染,且多重耐药性使其在医院环境中构成严重威胁。本研究的目的是评估我院洋葱伯克霍尔德菌感染的流行病学情况。

方法

根据感染控制委员会的记录,对五年期间医院内洋葱伯克霍尔德菌感染的发病率、临床特征、抗菌药物敏感性及转归进行回顾性分析。

结果

本研究共纳入39例医院内洋葱伯克霍尔德菌感染病例。洋葱伯克霍尔德菌占医院分离菌株的0.7%。其发病率为每1000例入院患者中有0.26例,粗死亡率为53.8%。医院内最常见的洋葱伯克霍尔德菌感染是肺炎(58.9%),其次是血流感染(25.6%)、手术部位感染(7.6%)、尿路感染(5.1%)和皮肤软组织感染(2.5%)。医院内洋葱伯克霍尔德菌感染最常发生在重症监护病房(61.5%)。最有效的抗菌药物是哌拉西林 - 他唑巴坦、头孢哌酮 - 舒巴坦和碳青霉烯类。

结论

我院医院内洋葱伯克霍尔德菌感染的发病率较低,研究期间未发现暴发情况。然而,由于在重症监护病房环境中其多重耐药导致高死亡率,应考虑由洋葱伯克霍尔德菌引起的感染。

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