Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China.
Department of Critical Care Medicine, XiaoLan Hospital of Southern Medical University, Zhongshan, Guangdong, P.R. China.
Surg Infect (Larchmt). 2021 Oct;22(8):845-853. doi: 10.1089/sur.2020.417. Epub 2021 Mar 26.
To investigate the risk factors for enterococcal intra-abdominal infections (EIAIs) and the association between EIAIs and outcomes in intensive care unit (ICU) patients. We reviewed retrospectively the records of patients with intra-abdominal infections admitted to the Department of Critical Care Medicine at Nanfang Hospital, Southern Medical University, China, from January 2011 to December 2018. Patients with intra-abdominal infections were divided into enterococcal and non-enterococcal groups based on whether enterococci were isolated from intra-abdominal specimens. A total of 431 patients with intra-abdominal infections were included, of whom 119 were infected with enterococci and 312 were infected with non-enterococci. Enterococci were isolated in 27.6% of patients, accounting for 24.5% (129/527) of all clinical bacterial isolates. Post-operative abdominal infection (adjusted odds ratio [OR], 2.361; p = 0.004), intestinal infection (adjusted OR, 2.703; p < 0.001), Mannheim Peritonitis Index score (MPI; adjusted OR, 1.052; p = 0.015), and use of antibiotic agents within the previous 90 days (adjusted OR, 1.880; p = 0.025) were associated with an increased risk of EIAIs. Compared with patients without enterococcal infection, ICU patients with enterococcal infection had a higher risk of failure of initial clinical therapy (49.6% vs. 24.2%; p < 0.001) and longer hospital stays (33 days [19, 48] vs. 18 days [12, 29]; p < 0.001). Enterococcal infection was associated with increased 28-day mortality, in-hospital mortality, and ICU mortality. However, no difference was found in length of ICU stay between the two groups. Additionally, there was no difference in ICU mortality, hospital mortality, or 28-day mortality in patients infected with enterococcus who did or did not receive empirical anti-enterococcal therapy. Post-operative abdominal infection, intestinal infection, MPI score, and use of antibiotic agents within the previous 90 days were independent risk factors for enterococcal infection. Enterococcal infection was associated with reduced short-term survival in ICU patients.
探讨肠球菌腹腔感染（EIAIs）的危险因素及 ICU 患者 EIAIs 与预后的关系。
回顾性分析 2011 年 1 月至 2018 年 12 月南方医科大学南方医院重症医学科收治的腹腔感染患者的临床资料。根据腹腔标本中是否分离出肠球菌，将腹腔感染患者分为肠球菌组和非肠球菌组。
共纳入 431 例腹腔感染患者，其中 119 例感染肠球菌，312 例感染非肠球菌。肠球菌的分离率为 27.6%，占所有临床细菌分离株的 24.5%（129/527）。术后腹部感染（校正优势比[OR]，2.361；p=0.004）、肠道感染（校正 OR，2.703；p<0.001）、曼海姆腹膜炎指数评分（MPI；校正 OR，1.052；p=0.015）和前 90 天使用抗生素（校正 OR，1.880；p=0.025）与 EIAIs 风险增加相关。与无肠球菌感染的 ICU 患者相比，肠球菌感染的 ICU 患者初始临床治疗失败的风险更高（49.6%比 24.2%；p<0.001），住院时间更长（33 天[19，48]比 18 天[12，29]；p<0.001）。肠球菌感染与 28 天病死率、院内病死率和 ICU 病死率升高有关。但两组 ICU 住院时间无差异。此外，未接受经验性抗肠球菌治疗的肠球菌感染患者与接受经验性抗肠球菌治疗的患者的 ICU 病死率、住院病死率和 28 天病死率无差异。术后腹部感染、肠道感染、MPI 评分和前 90 天使用抗生素是肠球菌感染的独立危险因素。肠球菌感染与 ICU 患者短期生存率降低有关。
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