产超广谱β-内酰胺酶（ESBL）肺炎克雷伯菌所致成人呼吸道感染的医院结局
Hospital Outcomes of Adult Respiratory Tract Infections with Extended-Spectrum B-Lactamase (ESBL) Producing Klebsiella Pneumoniae.
作者信息
Loh Li-Cher, Raman Sree, Thayaparan Tarmizi, Kumar Shalini
机构信息
IMU Lung Research, International Medical University, Kuala Lumpur, Malaysia;
出版信息
Malays J Med Sci. 2007 Jul;14(2):36-40.
Klebsiella pneumoniae ranks high as a cause of adult pneumonia requiring hospitalization in Malaysia. To study whether extended-spectrum b-lactamase (ESBL) producing K. pneumoniae was linked to hospital outcomes, we retrospectively studied 441 cases of adult respiratory tract infections with microbial proven K. pneumoniae from an urban-based university teaching hospital between 2003 and 2004. 47 (10.6%) cases had ESBL. Requirement for ventilation and median length of hospital stay, were greater in 'ESBL' than in 'non-ESBL' group [34% vs. 7.4%, p<0.001; 14 days vs. 5 days, p<0.001 respectively] but not crude hospital mortality rate [21.3% vs. 12.4%, p=0.092]. There was a four-fold increased risk of requiring ventilation [4.61 (2.72-7.85)] when ESBL was present. Our findings support the association of ESBL producing K. pneumoniae with adversed hospital outcomes and reiterate the need for vigilance on the part of treating clinicians.
肺炎克雷伯菌是马来西亚成年患者因肺炎需住院治疗的主要病因之一。为研究产超广谱β-内酰胺酶（ESBL）的肺炎克雷伯菌是否与住院结局相关，我们对一所城市大学教学医院2003年至2004年间441例经微生物学证实的成年肺炎克雷伯菌呼吸道感染病例进行了回顾性研究。47例（10.6%）病例产ESBL。“产ESBL组”的通气需求和中位住院时间均高于“非产ESBL组”[分别为34%对7.4%，p<0.001；14天对5天，p<0.001]，但粗住院死亡率无差异[21.3%对12.4%，p=0.092]。产ESBL时通气需求风险增加四倍[4.61（2.72 - 7.85）]。我们的研究结果支持产ESBL的肺炎克雷伯菌与不良住院结局相关，并再次强调治疗临床医生需保持警惕。
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