Infectious Diseases and Clinical Microbiology Department, School of Medicine, Başkent University, Istanbul, Turkey.
Infectious Diseases and Clinical Microbiology Department, School of Medicine, Koç University, Istanbul, Turkey.
J Hosp Infect. 2018 Mar;98(3):260-263. doi: 10.1016/j.jhin.2017.11.014. Epub 2017 Dec 15.
This article describes the emergence of resistance and predictors of fatality for 1556 cases of healthcare-associated Gram-negative bloodstream infection in 2014 and 2015. The colistin resistance rate in Klebsiella pneumoniae was 16.1%, compared with 6% in 2013. In total, 660 (42.4%) cases were fatal. The highest fatality rate was among patients with Acinetobacter baumannii bacteraemia (58%), followed by Pseudomonas aeruginosa (45%), Klebsiella pneumoniae (41%), Enterobacter cloacae (32%) and Escherichia coli (28%). On multi-variate analysis, the minimum inhibitory concentrations for carbapenems [odds ratio (OR) 1.02, 95% confidence interval (CI) 1.01-1.04; P = 0.002] and colistin (OR 1.1, 95% CI 1.03-1.17; P = 0.001) were found to be significantly associated with fatality.
本文描述了 2014 年和 2015 年 1556 例与医疗保健相关的革兰氏阴性菌血流感染病例中耐药性的出现和致死率的预测因素。肺炎克雷伯菌的粘菌素耐药率为 16.1%，而 2013 年为 6%。共有 660 例（42.4%）死亡。死亡率最高的是鲍曼不动杆菌菌血症患者（58%），其次是铜绿假单胞菌（45%）、肺炎克雷伯菌（41%）、阴沟肠杆菌（32%）和大肠杆菌（28%）。多变量分析发现，碳青霉烯类药物 [比值比（OR）1.02，95%置信区间（CI）1.01-1.04；P=0.002] 和粘菌素 [OR 1.1，95% CI 1.03-1.17；P=0.001] 的最低抑菌浓度与病死率显著相关。
