Enoch David A, Kuzhively Julie, Sismey Andrew, Grynik Alina, Karas Johannis Andreas
Clinical Microbiology and Public Health Laboratory, Peterborough and Stamford Hospitals NHS Foundation Trust , Peterborough City Hospital, Bretton Gate, Peterborough.
Department of Medicine, Peterborough and Stamford Hospitals NHS Foundation Trust , Peterborough City Hospital, Bretton Gate, Peterborough.
Infect Dis Rep. 2013 Sep 11;5(1):e4. doi: 10.4081/idr.2013.e4. eCollection 2013 Jan 22.
Pseudomonas aeruginosa bacteraemia is associated with significant morbidity and mortality. We retrospectively studied the epidemiology of bacteraemia due to P. aeruginosa in two UK district hospitals so as to determine prevention strategies and assess the efficacy and compliance with local hospital antibiotic guidelines. Eighty six episodes occurred in 85 patients over the 3 year period. There was a year on year increase in bacteraemias, due predominantly to an increased proportion of community-onset episodes. Urinary catheterisation was a significant risk factor, along with anaemia, renal disease, malignancy and diabetes. The antibiotic guidelines were adequate for 92.8% of episodes but only 73.8% of patients received adequate therapy. Failure to follow the guidelines was principally due to unwillingness to use gentamicin due to concerns about nephrotoxicity. The antibiotic guidelines may need reviewing to accommodate this problem and further work is required to address urinary catheter care in both the hospital and community. Pseudomonas aeruginosa should be considered a significant pathogen when patients are admitted with features of sepsis.
铜绿假单胞菌血症与显著的发病率和死亡率相关。我们回顾性研究了英国两家地区医院中由铜绿假单胞菌引起的菌血症的流行病学情况，以确定预防策略，并评估当地医院抗生素指南的有效性及遵循情况。在3年期间，85名患者发生了86次菌血症发作。菌血症逐年增加，主要原因是社区发病的比例增加。导尿是一个重要的危险因素，贫血、肾病、恶性肿瘤和糖尿病也是。抗生素指南对92.8%的发作情况适用，但只有73.8%的患者接受了充分的治疗。未遵循指南主要是由于担心庆大霉素的肾毒性而不愿使用。可能需要重新审视抗生素指南以解决这个问题，并且需要进一步开展工作来解决医院和社区中的导尿管护理问题。当患者因败血症特征入院时，应将铜绿假单胞菌视为重要病原体。
