Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan, Seoul, Republic of Korea.
Diagn Microbiol Infect Dis. 2014 Apr;78(4):457-61. doi: 10.1016/j.diagmicrobio.2013.08.011. Epub 2014 Jan 23.
We performed a case-control study to identify risk factors of carbapenem-resistant Gram-negative bacteria (CRGNB) as an increasing cause of hospital-acquired pneumonia (HAP). The study included critically ill adult patients with HAP whose microbial etiology was identified at eight tertiary centers in Korea between June 2008 and December 2009. Eighty two patients with 86 isolates of CRGNB (62 Acinetobacter baumannii, 14 Pseudomonas aeruginosa, and 10 Stenotrophomonas maltophilia) were included in the case group, and 122 patients with carbapenem-susceptible Gram-negative bacteria were included in the control group. Diabetes mellitus (adjusted odds ratio [aOR] 2.82, 95% confidence interval [95% CI] 1.25-6.38), radiologic score ≥5 (aOR 4.56, 95% CI 2.36-8.81), prior fluoroquinolone (aOR 2.39. 95% CI = 1.07-5.35), or carbapenem usage (aOR 2.82, 95% CI 1.75-17.83) were found to be independent risk factors. Fluoroquinolone and carbapenem should be cautiously used to avoid HAP caused by CRGNB.
我们进行了一项病例对照研究，以确定碳青霉烯类耐药革兰氏阴性菌 (CRGNB) 作为医院获得性肺炎 (HAP) 日益增加的病因的危险因素。该研究包括 2008 年 6 月至 2009 年 12 月在韩国的 8 家三级中心确定微生物病因的重症 HAP 成年患者。82 例患者（86 株 CRGNB，62 株鲍曼不动杆菌、14 株铜绿假单胞菌和 10 株嗜麦芽窄食单胞菌）被纳入病例组，122 例碳青霉烯类敏感革兰氏阴性菌患者被纳入对照组。糖尿病（调整后的优势比 [aOR] 2.82，95%置信区间 [95%CI] 1.25-6.38）、影像学评分≥5（aOR 4.56，95%CI 2.36-8.81）、氟喹诺酮类药物（aOR 2.39，95%CI 1.07-5.35）或碳青霉烯类药物使用史（aOR 2.82，95%CI 1.75-17.83）是独立的危险因素。应谨慎使用氟喹诺酮类和碳青霉烯类药物，以避免由 CRGNB 引起的 HAP。
