Cillóniz Catia, de la Calle Cristina, Dominedò Cristina, García-Vidal Carolina, Cardozo Celia, Gabarrús Albert, Marco Francesc, Torres Antoni, Soriano Alex
Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB) -SGR 911- Ciber de Enfermedades Respiratorias (Ciberes), 08036 Barcelona, Spain.
Department of Infectious Disease, Hospital Clinic of Barcelona, 08036 Barcelona, Spain.
J Clin Med. 2019 Aug 1;8(8):1150. doi: 10.3390/jcm8081150.
We aimed to analyze the impact of cefotaxime non-susceptibility on the 30-day mortality rate in patients receiving a third-generation cephalosporin for pneumococcal bacteremic pneumonia.
We conducted a retrospective observational study of prospectively collected data from the Hospital Clinic of Barcelona. All adult patients with monomicrobial bacteremic pneumonia due to and treated with a third-generation cephalosporin from January 1991 to December 2016 were included. Risk factors associated with 30-day mortality were evaluated by univariate and multivariate analyses.
During the study period, 721 eligible episodes were identified, and data on the susceptibility to cefotaxime was obtainable for 690 episodes. Sixty six (10%) cases were due to a cefotaxime non-susceptible strain with a 30-day mortality rate of 8%. Variables associated with 30-day mortality were age, chronic liver disease, septic shock, and the McCabe score. Infection by a cefotaxime non-susceptible did not increase the mortality rate.
Despite the prevalence of cefotaxime, non-susceptible has increased in recent years. We found no evidence to suggest that patients hospitalized with bacteremic pneumonia due to these strains had worse clinical outcomes than patients with susceptible strains.
我们旨在分析头孢噻肟不敏感对接受第三代头孢菌素治疗肺炎球菌菌血症性肺炎患者30天死亡率的影响。
我们对巴塞罗那医院诊所前瞻性收集的数据进行了一项回顾性观察研究。纳入了1991年1月至2016年12月期间所有因肺炎球菌菌血症性肺炎接受第三代头孢菌素治疗的成年患者。通过单因素和多因素分析评估与30天死亡率相关的危险因素。
在研究期间，共确定了721例符合条件的病例，其中690例可获得头孢噻肟敏感性数据。66例（10%）病例由头孢噻肟不敏感菌株引起，30天死亡率为8%。与30天死亡率相关的变量有年龄、慢性肝病、感染性休克和麦凯布评分。头孢噻肟不敏感肺炎球菌感染并未增加死亡率。
尽管头孢噻肟普遍使用，但近年来不敏感肺炎球菌的比例有所增加。我们没有发现证据表明因这些菌株导致菌血症性肺炎住院的患者比敏感菌株患者的临床结局更差。
