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中国一家三级医院中耐多药革兰阴性菌所致医院获得性脑膜炎患者的结局及影响因素:一项回顾性研究

Outcome and factors of patients with nosocomial meningitis by multi-drug-resistant Gram-negative bacteria in a tertiary hospital in China: a retrospective study.

作者信息

Chen Yue, Li Fengtian, Zhu Man, Liu Lei, Luo YanPing

机构信息

Center of Clinical Pharmacy, Chinese PLA General Hospital, Beijing, China.

Center for Clinical Laboratory Medicine, Chinese PLA General Hospital, Beijing, China.

出版信息

Br J Neurosurg. 2020 Jun;34(3):324-328. doi: 10.1080/02688697.2019.1710819. Epub 2020 Feb 7.

Abstract

Few data are available on the risk factors involved in nosocomial meningitis from multi-drug-resistant Gram-negative bacteria (MDR-GNB). Our aim was to identify the risk factors of prognosis for MDR-GNB nosocomial meningitis. Retrospective study of patients undergoing neurosurgery and with positive cerebrospinal fluid culture results post operation between January 2012 and January 2017 in a tertiary hospital in China. In total, 3533 patients were screened. Forty patients with meningitis and completed data were included and divided into two groups, 29 who survived in the successful group (SG) and 11 who died in the failed group (FG). Statistically significant different factors involved in treating successful and failed were pathogen types, highest body temperature in the first 24h of symptoms, CSF glucose content and meropenem susceptibility (for ). The most common pathogen in the failed ones is with meropenem MIC ≥ 16mg/L. Treatment of MDR-GNB nosocomial meningitis is more likely to fail in patients with severe condition when symptoms occur and infected by . Researches with larger population are needed to find more factors to improve patient outcome.

摘要

关于耐多药革兰氏阴性菌(MDR - GNB)引起的医院获得性脑膜炎的危险因素,目前可用的数据较少。我们的目的是确定MDR - GNB医院获得性脑膜炎预后的危险因素。对2012年1月至2017年1月在中国一家三级医院接受神经外科手术且术后脑脊液培养结果呈阳性的患者进行回顾性研究。总共筛选了3533例患者。纳入40例患有脑膜炎且数据完整的患者,并将其分为两组,成功组(SG)中有29例存活,失败组(FG)中有11例死亡。治疗成功与失败涉及的具有统计学显著差异的因素有病原菌类型、症状出现后最初24小时内的最高体温、脑脊液葡萄糖含量和美罗培南敏感性(针对……)。失败组中最常见的病原菌是美罗培南最低抑菌浓度≥16mg/L的……。当出现症状且受……感染时,病情严重的患者发生MDR - GNB医院获得性脑膜炎的治疗更有可能失败。需要进行更大规模人群的研究以找到更多改善患者预后的因素。

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