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血流感染的流行病学和死亡风险因素:日本单中心回顾性研究。

Epidemiology and risk factors for mortality in bloodstream infections: A single-center retrospective study in Japan.

机构信息

Division of Infection Control Sciences, Department of Clinical Pharmacy, School of Pharmacy, Showa University, Tokyo, Japan; Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan.

Division of Infection Control Sciences, Department of Clinical Pharmacy, School of Pharmacy, Showa University, Tokyo, Japan.

出版信息

Am J Infect Control. 2018 Dec;46(12):e75-e79. doi: 10.1016/j.ajic.2018.06.019. Epub 2018 Aug 29.

Abstract

BACKGROUND

Few published data are available on the morbidity and mortality of bloodstream infections (BSIs) in Japan. We sought to investigate the epidemiology of BSIs, the involvement of antimicrobial resistance, and the factors that influence patient prognosis.

METHODS

This single-center study retrospectively evaluated patients who were found to have positive blood cultures at a tertiary teaching hospital between January 2012 and December 2016.

RESULTS

A total of 2,105 patients with BSIs were included; 1,786 survived and 319 died, and the 30-day mortality rate was 15.2% over the 5-year study period. BSIs caused by yeasts were independently associated with 30-day mortality. The 30-day mortality rate of BSIs caused by extended-spectrum beta lactamase-producing gram-negative bacteria was significantly higher than that of BSIs caused by nonproducing bacteria.

DISCUSSION

The differences in mortality may be caused by differences in the distribution of pathogens and in the delivery of health care.

CONCLUSIONS

This study reported epidemiology and antimicrobial resistance data of BSIs in Japan and identified several risk factors associated with 30-day mortality. National surveillance of BSIs is required in Japan for comparison with other countries.

摘要

背景

关于日本血流感染(BSI)的发病率和死亡率,目前仅有少量已发表的数据。我们旨在调查血流感染的流行病学、抗菌药物耐药性的参与情况以及影响患者预后的因素。

方法

这项单中心研究回顾性评估了 2012 年 1 月至 2016 年 12 月期间在一家三级教学医院发现的血培养阳性患者。

结果

共纳入 2105 例血流感染患者,1786 例存活,319 例死亡,5 年研究期间 30 天死亡率为 15.2%。酵母引起的血流感染与 30 天死亡率独立相关。产超广谱β内酰胺酶革兰氏阴性菌引起的血流感染的 30 天死亡率明显高于非产酶菌引起的血流感染。

讨论

死亡率的差异可能是由病原体的分布和医疗保健的提供方式不同引起的。

结论

本研究报告了日本血流感染的流行病学和抗菌药物耐药性数据,并确定了与 30 天死亡率相关的几个风险因素。日本需要进行全国性的血流感染监测,以便与其他国家进行比较。

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