Lebanese University, Faculty of Pharmacy, Beirut, Lebanon.
Lebanese University, Faculty of Pharmacy, Beirut, Lebanon; Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm - Université de Bordeaux, France; Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; Saint-Joseph University, Faculty of Pharmacy, Beirut, Lebanon; Holy Spirit University of Kaslik, Faculty of Medicine and Medical Sciences, Kaslik, Lebanon.
J Infect Public Health. 2018 May-Jun;11(3):405-411. doi: 10.1016/j.jiph.2017.09.005. Epub 2017 Sep 29.
The objective of this study is to identify and characterize the species resistance of different pathogens between community acquired and hospital acquired infections pointing at patients' related independent co-morbidities and socio-demographic factors.
It was a retrospective cohort, multicenter study from five private hospitals located in Beirut and Mount Lebanon. Two hundred fifty-eight adult patients were included.
110 Gram negative pathogens and 26 Gram positive pathogens were implicated in hospital acquired infections. The Gram-negative bacteria that showed a positive correlation regarding patient's type of infection were Pseudomonas aeruginosa (12%), Klebsiella pneumoniae (6.2%) and Acinetobacter baumannii (3.1%). These bacteria were more frequent in patients with hospital acquired infections (P=0.002, 0.013 and 0.017 respectively). The ratio of methicillin resistant Staphylococcus aureus, Extended Spectrum Beta Lactamase producing Escherichia coli and K. pneumoniae and multi drug P. aeruginosa showed high significance in hospital acquired infections. The logistic regression, showed a significant relationship between resistant bacteria and age (p<0.001, ORa=5.680, CI [2.344; 13.765]) and immunosuppressed state (p=0.003, ORa=3.137, CI [1.485; 6.630]) and an inverse relationship for Chronic Obstructive Pulmonary Disease (COPD) (p=0.006, ORa=0.403, CI [0.212; 0.765]).
Our results confirm that hospital acquired infections/bacteria have higher rates of resistance when compared to community acquired; these rates increase with age, immunosuppression and are inversely proportional with COPD. Therefore, physicians should be aware of patients' comorbidities to properly guide initial therapy.
本研究旨在确定和描述社区获得性和医院获得性感染中不同病原体的耐药性，重点关注与患者相关的独立合并症和社会人口因素。
这是一项回顾性队列、多中心研究，涉及贝鲁特和黎巴嫩山的五家私立医院。共纳入 258 例成年患者。
110 种革兰氏阴性病原体和 26 种革兰氏阳性病原体与医院获得性感染有关。与患者感染类型呈正相关的革兰氏阴性细菌为铜绿假单胞菌（12%）、肺炎克雷伯菌（6.2%）和鲍曼不动杆菌（3.1%）。这些细菌在医院获得性感染患者中更为常见（P=0.002、0.013 和 0.017 分别）。耐甲氧西林金黄色葡萄球菌、产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌以及多药耐药铜绿假单胞菌的比率在医院获得性感染中显示出高度显著性。逻辑回归显示，耐药菌与年龄（p<0.001，ORa=5.680，CI [2.344; 13.765]）和免疫抑制状态（p=0.003，ORa=3.137，CI [1.485; 6.630]）之间存在显著关系，与慢性阻塞性肺疾病（COPD）呈反比关系（p=0.006，ORa=0.403，CI [0.212; 0.765]）。
我们的结果证实，与社区获得性感染相比，医院获得性感染/细菌的耐药率更高；这些比率随着年龄的增长、免疫抑制和与 COPD 的反比关系而增加。因此，医生应了解患者的合并症，以便正确指导初始治疗。
