Infection Control Unit, University Hospital of Heraklion, Crete, Greece.
Eur J Clin Microbiol Infect Dis. 2010 Mar;29(3):301-5. doi: 10.1007/s10096-009-0857-7.
Clinical reports on infections by pandrug-resistant (PDR) bacteria are scarce. This observational case series study was conducted during a 2-year period at a university hospital. Patients infected by PDR gram-negative bacteria comprised the study cohort. An isolate was defined as PDR if it was resistant to all antibiotic classes available for empirical treatment. A total of 21 patients infected by PDR gram-negative bacteria were recorded. The mean APACHE II score on admission was 18.8, the mean Charlson comorbidity index was 2.9, and 20 (95.2%) patients had a history of intensive care unit hospitalization. All patients had recent exposure to multiple antibiotics (median, 6 antibiotic groups). Infections occurred at a mean of 41.5 days after admission. The mean length of stay after infection was 54.6 days and 5 (23.8%) patients died due to the infection. Treatment was mainly based on a colistin-containing regimen (47.6%) or tigecycline (33.3%). All patients treated with tigecycline had total resolution of the infection and a notably shorter length of hospital stay after infection. In conclusion, PDR gram-negative bacterial infections are associated with considerable prolongation of hospitalization and mortality, although the mortality is not as high as that expected. Tigecycline appears to be effective for the successful treatment of PDR infections
临床报告中关于泛耐药（PDR）细菌感染的病例较为少见。本观察性病例系列研究在一家大学医院进行，为期 2 年。将感染 PDR 革兰氏阴性菌的患者作为研究队列。如果分离株对所有可供经验性治疗的抗生素类别均具有耐药性，则将其定义为 PDR。共记录了 21 例感染 PDR 革兰氏阴性菌的患者。入院时平均急性生理学与慢性健康状况评分系统 II （APACHE II）评分为 18.8，平均 Charlson 合并症指数为 2.9，20 例（95.2%）患者有重症监护病房住院史。所有患者均有近期接触多种抗生素（中位数为 6 种抗生素组）的病史。感染发生在入院后平均 41.5 天。感染后的平均住院时间为 54.6 天，5 例（23.8%）患者因感染而死亡。治疗主要基于包含黏菌素的方案（47.6%）或替加环素（33.3%）。所有接受替加环素治疗的患者均完全缓解感染，且感染后住院时间明显缩短。总之，PDR 革兰氏阴性菌感染会导致住院时间明显延长和死亡率升高，尽管死亡率并未如预期的那么高。替加环素似乎对成功治疗 PDR 感染有效。
