感染部位和抗生素选择在治疗耐碳青霉烯铜绿假单胞菌败血症中的重要性。
Importance of Site of Infection and Antibiotic Selection in the Treatment of Carbapenem-Resistant Pseudomonas aeruginosa Sepsis.
机构信息
Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri, USA
Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri, USA.
出版信息
Antimicrob Agents Chemother. 2018 Mar 27;62(4). doi: 10.1128/AAC.02400-17. Print 2018 Apr.
Abstract
In a retrospective analysis of 215 patients with carbapenem-resistant sepsis, we observed a significantly higher risk of mortality associated with respiratory tract infection (risk ratio [RR], 1.20; 95% confidence interval [CI], 1.04 to 1.39; = 0.010) and lower risk with urinary tract infection (RR, 0.80; 95% CI, 0.71 to 0.90; = 0.004). Aminoglycoside monotherapy was associated with increased mortality, even after adjusting for confounders (adjusted RR, 1.72; 95% CI, 1.03 to 2.85; = 0.037), consistent across multiple sites of infection.
摘要
在对 215 例碳青霉烯类耐药脓毒症患者进行回顾性分析时，我们观察到与呼吸道感染（风险比 [RR]，1.20；95%置信区间 [CI]，1.04 至 1.39；=0.010）相关的死亡率显著升高，而与尿路感染（RR，0.80；95%CI，0.71 至 0.90；=0.004）相关的死亡率则显著降低。即使在调整了混杂因素后，氨基糖苷类单药治疗与死亡率增加相关（调整后的 RR，1.72；95%CI，1.03 至 2.85；=0.037），且在多个感染部位均如此。
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Open Forum Infect Dis. 2017 Aug 16;4(3):ofx176. doi: 10.1093/ofid/ofx176. eCollection 2017 Summer.
2
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3
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014.与医疗保健相关感染有关的耐抗菌性病原体：2011 - 2014年向疾病控制与预防中心国家医疗保健安全网络报告的数据摘要
Infect Control Hosp Epidemiol. 2016 Nov;37(11):1288-1301. doi: 10.1017/ice.2016.174. Epub 2016 Aug 30.
4
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Emerg Microbes Infect. 2016 Mar 23;5(3):e27. doi: 10.1038/emi.2016.22.
5
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6
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Int J Antimicrob Agents. 2013 Dec;42(6):492-6. doi: 10.1016/j.ijantimicag.2013.09.002. Epub 2013 Oct 1.
7
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8
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9
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Chest. 1992 Jun;101(6):1644-55. doi: 10.1378/chest.101.6.1644.
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