中国菌血症住院患者的死亡风险因素：耐药情况对死亡率的影响
Risk Factors for Mortality of Inpatients with Bacteremia in China: Impact of Resistance Profile in the Mortality.
作者信息
Zhang Yulin, Li Yi, Zeng Ji, Chang Yanzi, Han Shouhua, Zhao Jiankang, Fan Yanyan, Xiong Zhujia, Zou Xiaohui, Wang Chunlei, Li Binbin, Li Haibo, Han Jiajing, Liu Xinmeng, Xia Yudi, Lu Binghuai, Cao Bin
机构信息
Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing 100029, People's Republic of China.
Department of Laboratory Medicine, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China.
出版信息
Infect Drug Resist. 2020 Nov 12;13:4115-4123. doi: 10.2147/IDR.S268744. eCollection 2020.
PURPOSE
Pseudomonas aeruginosa bacteremia presents a severe challenge to hospitalized patients. However, to date, the risk factors for mortality among inpatients with bacteremia in China remain unclear.
PATIENTS AND METHODS
This retrospective multicenter study was performed to analyze 215 patients with culture-confirmed bacteremia in five healthcare centers in China during the years 2012-2019.
RESULTS
Of 215 patients with bacteremia, 61 (28.4%) died during the study period. Logistic multivariable analysis revealed that cardiovascular disease (OR=3.978, =0.001), blood transfusion (OR=5.855, <0.001) and carbapenem-resistant (CRPA) phenotype (OR=4.485, =0.038) constituted the independent risk factors of mortality. Furthermore, both CRPA and multidrug-resistant (MDRPA) phenotypes were found to be significantly associated with 5-day mortality (Log-rank, <0.05).
CONCLUSION
This study revealed a high mortality rate amongst hospitalized patients with bacteremia, and those with cardiovascular diseases, CRPA and MDRPA phenotypes, should be highlighted and given appropriate management in China.
目的
铜绿假单胞菌血症对住院患者构成严峻挑战。然而，迄今为止，中国住院菌血症患者的死亡危险因素仍不明确。
患者与方法
本回顾性多中心研究旨在分析2012年至2019年期间中国五个医疗中心的215例血培养确诊的菌血症患者。
结果
在215例菌血症患者中，61例（28.4%）在研究期间死亡。多因素logistic分析显示，心血管疾病（OR=3.978，P=0.001）、输血（OR=5.855，P<0.001）和耐碳青霉烯类（CRPA）表型（OR=4.485，P=0.038）是死亡的独立危险因素。此外，CRPA和多重耐药（MDRPA）表型均与5天死亡率显著相关（Log-rank，P<0.05）。
结论
本研究显示住院菌血症患者死亡率较高，在中国，患有心血管疾病、CRPA和MDRPA表型的患者应受到重视并给予适当管理。
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