Tedja Rudy, Nowacki Amy, Fraser Thomas, Fatica Cynthia, Griffiths Lori, Gordon Steven, Isada Carlos, van Duin David
Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH.
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
Am J Infect Control. 2014 May;42(5):542-5. doi: 10.1016/j.ajic.2013.12.009. Epub 2014 Mar 14.
Multidrug-resistant (MDR) organisms in ventilator-associated pneumonia were found in 49 of 107 patients and were associated with home antibiotics, pre-ventilator-associated pneumonia hospital stay, and health care exposure. Overall, MDR organisms were associated with increased mortality (P = .006). On multivariate analysis, MDR status was modulated by organism class. In nonfermenting gram-negative rods, no association between MDR and mortality was found, but, in all other organisms, MDR was associated with increased mortality risk (hazard ratio, 6.15; 95% confidence interval: 1.80-21.05, P = .004).
107例患者中有49例在呼吸机相关性肺炎中发现多重耐药（MDR）菌，这些菌与家庭使用抗生素、呼吸机相关性肺炎发生前的住院时间以及医疗保健暴露有关。总体而言，MDR菌与死亡率增加相关（P = .006）。多因素分析显示，MDR状态受菌种类别影响。在非发酵革兰阴性杆菌中，未发现MDR与死亡率之间存在关联，但在所有其他菌种中，MDR与死亡风险增加相关（风险比为6.15；95%置信区间：1.80 - 21.05，P = .004）。
