Faculty of Health, Witten/Herdecke University, Witten, Germany.
Department of Emergency Medicine, Mönchengladbach Municipal Hospital, Mönchengladbach, Germany.
Palliat Med. 2020 Jun;34(6):776-783. doi: 10.1177/0269216320911591. Epub 2020 Mar 18.
Multidrug-resistant organisms are a growing challenge and burden to patient care. To date, there are only data concerning the prevalence of methicillin-resistant infections. Thus, numbers of other multidrug-resistant organisms can only be extrapolated and inferred from more or less comparable cohorts.
To evaluate the prevalence of multidrug-resistant organisms on palliative care in-patients.
A prospective cohort analysis.
SETTING/PARTICIPANTS: A University Hospital-bound palliative care unit, in which all patients admitted to the unit were screened for inclusion.
In total, 304 patients were included in this study. The prevalence for methicillin-resistant of 5.2% (95% confidence interval: 2.9%-8.4%), for vancomycin-resistant of 10.5% (95% confidence interval: 7.2%-14.8%), for Ciprofloxacin-resistant-extended spectrum beta-lactamases isolates of 5.8% (95% confidence interval: 3.4%-9.3%) and Ciprofloxacin-resistant Carbapenem-resistant Gram-negative bacteria of 0.3% (95% confidence interval: 0%-1.3%) was calculated. Except for methicillin-resistant , patients carrying a multidrug-resistant organism had a significant longer duration of hospitalization. Median length of stay was 12 days (interquartile range: 14.5, no multidrug-resistant organisms), 14.5 days (interquartile range: 15, methicillin-resistant ), 21 days (interquartile range: 16.5, vancomycin-resistant enterococci), 22 days (interquartile range: 20.75, Ciprofloxacin-resistant-extended spectrum beta-lactamases) and 32 days (interquartile range: 22.00) for patients carrying two organisms.
There is a high prevalence of all multidrug-resistant organisms within the hospitalized palliative care patients. However, the multidrug-resistant organisms do not seem to impact the survival within this cohort. Further studies should evaluate additional end-points, for example, quality of life, which are of special interest in this cohort.
多药耐药菌对患者的治疗构成了日益严重的挑战和负担。迄今为止，仅有关耐甲氧西林感染的数据。因此，其他多药耐药菌的数量只能从或多或少可比的队列中推断出来。
评估姑息治疗住院患者中多药耐药菌的流行情况。
前瞻性队列分析。
地点/参与者：一所大学附属医院的姑息治疗病房，该病房内所有入院患者均接受纳入筛选。
本研究共纳入 304 例患者。耐甲氧西林金黄色葡萄球菌的流行率为 5.2%（95%置信区间：2.9%-8.4%），万古霉素耐药肠球菌为 10.5%（95%置信区间：7.2%-14.8%），环丙沙星耐药-扩展谱β-内酰胺酶分离株为 5.8%（95%置信区间：3.4%-9.3%），环丙沙星耐药-碳青霉烯类耐药革兰氏阴性菌为 0.3%（95%置信区间：0%-1.3%）。除耐甲氧西林金黄色葡萄球菌外，携带多药耐药菌的患者住院时间明显更长。中位住院时间分别为 12 天（四分位间距：14.5，无多药耐药菌）、14.5 天（四分位间距：15，耐甲氧西林金黄色葡萄球菌）、21 天（四分位间距：16.5，万古霉素耐药肠球菌）、22 天（四分位间距：20.75，环丙沙星耐药-扩展谱β-内酰胺酶）和 32 天（四分位间距：22.00）。
住院姑息治疗患者中存在多种多药耐药菌的高流行率。然而，多药耐药菌似乎不会影响本队列的生存率。进一步的研究应评估其他终点，例如生活质量，这在本队列中特别重要。
