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欧洲的皮肤感染:一项回顾性研究,分析发病率、患者特征和治疗模式。

Skin infections in Europe: a retrospective study of incidence, patient characteristics and practice patterns.

机构信息

Department of Medicine and Surgery, Section of Infectious Diseases, University of Insubria, Varese, Italy.

Αngelini Pharma S.p.A., Rome, Italy.

出版信息

Int J Antimicrob Agents. 2022 Sep;60(3):106637. doi: 10.1016/j.ijantimicag.2022.106637. Epub 2022 Jul 9.

Abstract

OBJECTIVE

Acute bacterial skin and skin structure infections (ABSSSIs) are associated with considerable morbidity and a heavy healthcare burden. The primary objectives of this two-phase study were to determine the incidence of skin infections and ABSSSIs in hospitalized patients (Phase A), and to describe the characteristics and treatment of hospitalized patients with ABSSSIs (Phase B).

METHODS

This non-interventional, retrospective study was based on data collected from adult patients hospitalized for skin infections in six European countries (Czech Republic, Greece, Italy, Portugal, Russia and Spain) between January 2014 and June 2016.

RESULTS

In Phase A, the total hospital incidence of skin infections and ABSSSIs was 2.4 and 1.8 per 1000 patient-days, respectively. Overall, 73.6% of 50,469 hospitalizations for skin infections were for ABSSSIs. Among the 750 patients with ABSSSIs included in Phase B, Gram-positive bacteria were isolated in 24.9%, most commonly methicillin-susceptible Staphylococcus aureus (11.5%). Empirical therapy was administered to 98.1% of patients, most often with a penicillin, with or without a β-lactamase inhibitor (42.1%). Complete cure was achieved in 46.5% and 34.5% of patients after initial treatment and treatment modification, respectively. Overall, 22.7% of patients had at least one additional ABSSSI-related hospitalization, 47.1% of patients visited the emergency room, 19.3% of patients visited primary care clinics, and 34.8% of patients visited a specialist.

CONCLUSION

Treatment of ABSSSIs in Europe is associated with a heavy healthcare burden, highlighting the need for optimized management strategies that may reduce healthcare utilization.

摘要

目的

急性细菌性皮肤和皮肤结构感染(ABSSSIs)与相当大的发病率和沉重的医疗负担有关。本两项研究的主要目的是确定住院患者皮肤感染和 ABSSSIs 的发生率(阶段 A),并描述 ABSSSIs 住院患者的特征和治疗方法(阶段 B)。

方法

这是一项非干预性、回顾性研究,基于 2014 年 1 月至 2016 年 6 月期间,来自六个欧洲国家(捷克共和国、希腊、意大利、葡萄牙、俄罗斯和西班牙)的因皮肤感染住院的成年患者的数据。

结果

在阶段 A 中,皮肤感染和 ABSSSIs 的总住院发生率分别为每 1000 患者日 2.4 和 1.8 例。总的来说,73.6%的 50469 例皮肤感染住院是 ABSSSIs。在阶段 B 中纳入的 750 例 ABSSSIs 患者中,24.9%分离出革兰阳性菌,最常见的是耐甲氧西林金黄色葡萄球菌(11.5%)。98.1%的患者接受了经验性治疗,最常用的是青霉素,加或不加β-内酰胺酶抑制剂(42.1%)。初始治疗和治疗调整后,分别有 46.5%和 34.5%的患者获得完全治愈。总的来说,22.7%的患者至少有一次因 ABSSSI 相关的再次住院,47.1%的患者去了急诊室,19.3%的患者去了初级保健诊所,34.8%的患者去了专科医生。

结论

欧洲 ABSSSIs 的治疗与沉重的医疗负担有关,这突出表明需要优化管理策略,以减少医疗利用。

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