Alrahmany Diaa, Omar Ahmed F, Al-Maqbali Salima R S, Harb Gehan, Ghazi Islam M
Pharmaceutical Care Department, Directorate General of Medical Supplies, Ministry of Health, Muscat HCX8+9PP, Oman.
General Medicine Department, Suhar Hospital, Sohar 8MGH+JFH, Oman.
Antibiotics (Basel). 2022 Jul 12;11(7):934. doi: 10.3390/antibiotics11070934.
G6PD deficiency is a genetic disease that weakens the immune system and renders affected individuals susceptible to infections. In the Sultanate of Oman resides a high number of recorded G6PD cases due to widespread consanguineous marriage, which may reach 25% of the population. We studied the infection patterns and risk factors for mortality to provide antimicrobial stewardship recommendations for these patients. After obtaining ethical approval, a registry of recorded cases was consulted retrospectively to include G6PD-deficient adult patients admitted to Suhar hospital over 5 years with microbiologically confirmed infections. Patient demographics, health-related information, infection causes, treatment, and clinical outcomes were studied. Data were analyzed to describe infection patterns and risk factors. Several variables, including underlying comorbidities and hospitalization details, such as length of stay, admission to critical care unit, blood transfusion, or exposure to an invasive procedure, were statistically associated with the acquisition of multidrug-resistant and hospital-acquired infections. Meanwhile, these infections were associated with a high mortality rate (28%), significantly associated with the patient's health status and earlier exposure to antimicrobial treatment due to previous bacterial infection. The high prevalence of G6PD deficiency among the Omani population should alert practitioners to take early action when dealing with such cases during infection that requires hospitalization. Strict infection control measures, Gram-negative empiric coverage, hospital discharge as early as possible, and potent targeted antimicrobial therapy in this patient population can ameliorate the treatment outcomes and should be emphasized by the antimicrobial stewardship team.
葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症是一种削弱免疫系统并使受影响个体易受感染的遗传疾病。由于近亲结婚普遍,阿曼苏丹国记录的G6PD病例数量众多,近亲结婚率可能达到人口的25%。我们研究了感染模式和死亡风险因素,为这些患者提供抗菌药物管理建议。在获得伦理批准后,我们回顾性查阅了已记录病例的登记册,纳入了5年来因微生物学确诊感染而入住苏哈尔医院的G6PD缺乏成年患者。对患者的人口统计学、健康相关信息、感染原因、治疗和临床结果进行了研究。对数据进行分析以描述感染模式和风险因素。包括潜在合并症和住院细节(如住院时间、入住重症监护病房、输血或接受侵入性操作)在内的几个变量与获得多重耐药和医院获得性感染在统计学上相关。同时,这些感染与高死亡率(28%)相关,这与患者的健康状况以及因先前细菌感染而较早接受抗菌治疗显著相关。阿曼人群中G6PD缺乏症的高患病率应提醒从业者在处理此类需要住院治疗的感染病例时尽早采取行动。严格的感染控制措施、针对革兰氏阴性菌的经验性覆盖、尽早出院以及对该患者群体采用有效的靶向抗菌治疗可以改善治疗结果,抗菌药物管理团队应予以强调。