Paediatric Infectious Diseases Unit, Red Cross War Memorial Children's Hospital and the Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
National Health Laboratory Service, Groote Schuur Hospital and Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa.
BMC Infect Dis. 2020 Oct 7;20(1):729. doi: 10.1186/s12879-020-05437-1.
This study describes the disease burden, clinical characteristics, antibiotic management, impact of multidrug resistance and outcome of Pseudomonas aeruginosa bloodstream infection (PABSI) among children admitted to a tertiary referral hospital for children in Cape Town, South Africa.
A retrospective descriptive study was conducted at a paediatric referral hospital in Cape Town, South Africa. Demographic and clinical details, antibiotic management and patient outcome information were extracted from medical and laboratory records. Antibiotic susceptibility results of identified organisms were obtained from the National Health Laboratory Service database.
The incidence risk of PABSI was 5.4 (95% CI: 4.34-6.54) PABSI episodes / 10,000 hospital admissions and the most common presenting feature was respiratory distress, 34/91 (37.4%). Overall, 69/91 (75.8%) of the PA isolates were susceptible to all antipseudomonal antibiotic classes evaluated. Fifty (54.9%) of the PABSI episodes were treated with appropriate empiric antibiotic therapy. The mortality rate was 24.2% and in multivariable analysis, empiric antibiotic therapy to which PA isolates were not susceptible, infections present on admission, and not being in the intensive care unit at the time that PABSI was diagnosed were significantly associated with 14-day mortality.
PABSI caused appreciable mortality, however, appropriate empiric antibiotic therapy was associated with reduced 14-day mortality.
本研究描述了南非开普敦一家三级转诊医院收治的儿童中铜绿假单胞菌血流感染（PABSI）的疾病负担、临床特征、抗生素管理、多重耐药的影响和结局。
在南非开普敦的一家儿科转诊医院进行了回顾性描述性研究。从医疗和实验室记录中提取人口统计学和临床特征、抗生素管理和患者结局信息。从国家卫生实验室服务数据库中获取鉴定病原体的抗生素药敏结果。
PABSI 的发病风险为 5.4（95%CI：4.34-6.54）PABSI 发作/10000 例住院，最常见的表现为呼吸窘迫，34/91（37.4%）。总体而言，91/91（75.8%）的 PA 分离株对评估的所有抗假单胞菌抗生素类别均敏感。50（54.9%）例 PABSI 发作采用了适当的经验性抗生素治疗。死亡率为 24.2%，多变量分析显示，PA 分离株对经验性抗生素治疗不敏感、入院时存在感染以及在诊断为 PABSI 时不在重症监护病房与 14 天死亡率显著相关。
PABSI 导致相当高的死亡率，但适当的经验性抗生素治疗与降低 14 天死亡率相关。
