Falagas Matthew E, Tansarli Giannoula S, Karageorgopoulos Drosos E, Vardakas Konstantinos Z
Emerg Infect Dis. 2014 Jul;20(7):1170-5. doi: 10.3201/eid2007.121004.
We evaluated the number of deaths attributable to carbapenem-resistant Enterobacteriaceae by using studies from around the world published before April 9, 2012. Attributable death was defined as the difference in all-cause deaths between patients with carbapenem-resistant infections and those with carbapenem-susceptible infections. Online databases were searched, and data were qualitatively synthesized and pooled in a metaanalysis. Nine studies met inclusion criteria: 6 retrospective case-control studies, 2 retrospective cohort studies, and 1 prospective cohort study. Klebsiella pneumoniae was the causative pathogen in 8 studies; bacteremia was the only infection in 5 studies. We calculated that 26%-44% of deaths in 7 studies were attributable to carbapenem resistance, and in 2 studies, which included bacteremia and other infections, -3% and -4% of deaths were attributable to carbapenem resistance. Pooled outcomes showed that the number of deaths was significantly higher in patients with carbapenem-resistant infections and that the number of deaths attributable to carbapenem resistance is considerable.
我们利用2012年4月9日前发表的来自世界各地的研究，评估了耐碳青霉烯类肠杆菌科细菌导致的死亡人数。可归因死亡定义为耐碳青霉烯类感染患者与碳青霉烯类敏感感染患者全因死亡的差异。检索了在线数据库，并对数据进行了定性综合和荟萃分析。9项研究符合纳入标准：6项回顾性病例对照研究、2项回顾性队列研究和1项前瞻性队列研究。8项研究中肺炎克雷伯菌为致病病原体；5项研究中菌血症是唯一的感染类型。我们计算得出，7项研究中26%-44%的死亡可归因于碳青霉烯类耐药，在2项包括菌血症和其他感染的研究中，-3%和-4%的死亡可归因于碳青霉烯类耐药。汇总结果显示，耐碳青霉烯类感染患者的死亡人数显著更高，且碳青霉烯类耐药导致的死亡人数相当可观。
