Department of Medicine, Hamad General Hospital, Doha, Qatar.
Travel Med Infect Dis. 2010 Nov;8(6):377-87. doi: 10.1016/j.tmaid.2010.10.004. Epub 2010 Nov 11.
We conducted a one-year observational study from July 2007 to June 2008 to describe the epidemiology of bacteraemia at Hamad general hospital. During this period, a total of 452 episodes of bacteraemia occurred, which corresponds to a rate of 19/1000 hospital admissions. Most patients 58.8% (266/452) had community acquired bacteraemia, and primary bacteraemia accounted for 62.2% (281/452) of the cases. The most common source of bacteraemia was intravenous catheterization in 19.2% (87/452) but no source was identified in 42.9% (194/452) of the episodes. Gram-negative organisms were isolated in 63.1% (285/452) episodes with Escherichia coli being the most frequent 21.5% (97/452). Multidrug resistance was observed in 33.3% (7/21) of all Pseudomonas aeruginosa isolates, 50% (6/12) of Acinetobacter isolates and 28.6% (6/21) of Enterobacter isolates, whereas all ESBL producing Klebsiella spp. and E. coli were multiresistant. The percentages of oxacillin resistant coagulase negative Staphylococci isolates and methicillin-resistant Staphylococcus aureus isolates were 81.8% (27/33) and 13.2% (7/53) respectively. In hospital mortality was 22.5% (102/452), and inadequate treatment and septic shock were found to be independent predictors of mortality. Therefore, bloodstream infection surveillance is crucial to produce meaningful guidelines for prevention (e.g., catheter-related) and empirical treatment of bacteraemia in Qatar.
我们进行了一项为期一年的观察性研究，从 2007 年 7 月至 2008 年 6 月，以描述哈马德综合医院的菌血症流行病学。在此期间，共发生 452 例菌血症，相当于每 1000 例住院患者中有 19 例。大多数患者（58.8%[266/452]）为社区获得性菌血症，原发性菌血症占 62.2%（452 例中有 281 例）。菌血症最常见的来源是静脉导管化，占 19.2%（452 例中有 87 例），但 42.9%（452 例中有 194 例）的病例未确定来源。革兰氏阴性菌在 63.1%（452 例中有 285 例）的病例中分离出来，其中大肠杆菌最常见，占 21.5%（452 例中有 97 例）。所有产 ESBL 的肺炎克雷伯菌和大肠埃希菌均为多重耐药菌，所有耐碳青霉烯类的铜绿假单胞菌和鲍曼不动杆菌分离株的多重耐药率分别为 33.3%（21 株中有 7 株）、50%（12 株中有 6 株）和 28.6%（21 株中有 6 株），而所有产 ESBL 的肺炎克雷伯菌和大肠埃希菌均为多重耐药菌。耐苯唑西林凝固酶阴性葡萄球菌和耐甲氧西林金黄色葡萄球菌的分离株分别占 81.8%（33 株中有 27 株）和 13.2%（53 株中有 7 株）。医院死亡率为 22.5%（452 例中有 102 例），治疗不充分和感染性休克被认为是死亡的独立预测因素。因此，血流感染监测对于在卡塔尔制定有意义的预防（如导管相关）和经验性治疗菌血症的指南至关重要。
