重症监护环境中多重耐药的患病率：一家三级教学医院的经验。
Prevalence of multidrug-resistant in a critical care setting: A tertiary teaching hospital experience.
作者信息
Alotaibi Thabit, Abuhaimed Abdulrhman, Alshahrani Mohammed, Albdelhady Ahmed, Almubarak Yousef, Almasari Osama
机构信息
Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
出版信息
SAGE Open Med. 2021 Mar 15;9:20503121211001144. doi: 10.1177/20503121211001144. eCollection 2021.
BACKGROUND
The management of infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region.
METHODS
We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors.
RESULTS
A comprehensive review of data identified 198 patients with . The prevalence of is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with , 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. We believe that multidrug-resistant is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.
背景
感染的管理被认为是一项挑战，尤其是在重症监护环境中。耐药率使得管理变得困难，并被认为会导致更高的死亡率。由于没有公开数据反映我们所在地区的人群情况，我们旨在调查[具体感染类型]的患病率，并探索不同的抗生素治疗方案如何影响患者的预后。
方法
我们对2013年1月1日至2017年12月31日在法赫德国王大学医院重症监护病房住院且实验室确诊为[具体感染类型]的所有成年感染患者进行了回顾性研究。从微生物科获取阳性培养结果，并选择符合纳入标准的患者。使用描述性分析和交叉表对变量进行分析。结果由不知情的共同作者进一步审查和审核。
结果
对数据的全面审查确定了198例[具体感染类型]患者。[具体感染类型]的患病率为3.37%，总死亡率为40.81%。我们的样本主要由男性患者组成，即68.7%，平均年龄为49岁，女性患者的平均年龄为56岁。幸存者的平均年龄低于非幸存者，即44.95岁。我们观察到，与幸存者相比，非幸存者之前使用抗生素的情况更多。从对感染[具体感染类型]患者的治疗回顾来看，65例仅接受了黏菌素治疗，18例接受了碳青霉烯类治疗，22例接受了碳青霉烯类和黏菌素联合治疗。感染患者的平均住院时间为20.25天。我们发现，接受碳青霉烯类治疗的患者的生存率高于接受黏菌素治疗的患者。我们认为多重耐药的[具体感染类型]很普遍，且与较高的死亡率相关，对每个重症监护病房医生来说都是一个具有挑战性的病例。需要进一步的前瞻性研究。
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