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[对49家医院急诊科接诊的1250例皮肤和软组织感染病例的回顾]

[Review of 1.250 episodes of skin and soft tissue infections attended at 49 hospital emergency departments].

作者信息

Llopis Ferran, González-Castillo Juan, Julián-Jiménez Agustín, Ferré Carles, Gamazo-Río Julio Javier, Martínez Mikel

机构信息

Ferran Llopis Roca, Servicio de Urgencias. Hospital Universitari de Bellvitge. Feixa Llarga s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain.

出版信息

Rev Esp Quimioter. 2014 Jun;27(2):115-21.

Abstract

OBJECTIVE

To review the prevalence, clinical characteristics, approach and outcome of patients with skin and soft tissue infections (SSTI) evaluated at the Emergency Departments (ED) in Spain.

METHODS

A descriptive multicenter cross-sectional analysis in 49 ED of patients with SSTI. Data were collected for age, gender, comorbid conditions, risk factors for multiresistant pathogens, STTI type, sepsis criteria, microbiology, antibiotic treatment, destination and ED mortality.

RESULTS

We documented 1,250 episodes (11% of all infections and 1.6% of all patients seen in ED), mean age 52 years (56% men) and the comorbidities and risk factors for major adverse outcomes were diabetes (15%), heart disease (12%), previous antibiotic therapy (10%) and solid malignancy (5%). 81% of STTI were nonnecrotizing, 3.3% had septic syndrome, in 65% of patients was not practised any microbiological study, and 16% had risk factors for infection for antibiotic-resistant gram-positive bacteria, with adequate empirical antibiotic therapy of 2.5%. 72% of patients were discharged home and 2 died. When comparing STTI discharged home respect those that were admitted, these latter were older patients with more comorbidities and risk factors for multidrug resistance, sepsis and there were more practised cultures (p < 0.05).

CONCLUSIONS

The SSTI have a prevalence of 1.6%, representing 11% of visits to the ED for infection. 44% of patients have comorbidity and 16% have risk factors for infection for resistant gram-positive pathogens and they were not made an appropriate antibiotic coverage.

摘要

目的

回顾在西班牙急诊科评估的皮肤和软组织感染(SSTI)患者的患病率、临床特征、诊治方法及结局。

方法

对49家急诊科的SSTI患者进行描述性多中心横断面分析。收集患者的年龄、性别、合并症、多重耐药病原体的危险因素、SSTI类型、脓毒症标准、微生物学、抗生素治疗、去向及急诊科死亡率等数据。

结果

我们记录了1250例病例(占所有感染的11%,占急诊科就诊患者的1.6%),平均年龄52岁(男性占56%),主要不良结局的合并症及危险因素包括糖尿病(15%)、心脏病(12%)、既往抗生素治疗史(10%)和实体恶性肿瘤(5%)。81%的SSTI为非坏死性,3.3%有脓毒症综合征,65%的患者未进行任何微生物学检查,16%有耐抗生素革兰氏阳性菌感染的危险因素,经验性抗生素治疗恰当率为2.5%。72%的患者出院回家,2例死亡。将出院回家的SSTI患者与住院患者进行比较,后者年龄更大,合并症更多,存在多重耐药、脓毒症的危险因素,且进行培养的比例更高(p<0.05)。

结论

SSTI的患病率为1.6%,占急诊科感染就诊病例的11%。44%的患者有合并症,16%有耐革兰氏阳性病原体感染的危险因素,且未得到恰当的抗生素覆盖。

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