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住院菌血症患者死亡的危险因素

Risk Factors for Mortality in Hospitalized Patients with Bacteremia.

作者信息

Jian Jiyong, Xie Zeqiang, Chen Liang

机构信息

Clinical Laboratory Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, People's Republic of China.

Peking University Ninth School of Clinical Medicine, Beijing, People's Republic of China.

出版信息

Infect Drug Resist. 2022 Jul 21;15:3881-3886. doi: 10.2147/IDR.S371129. eCollection 2022.

Abstract

OBJECTIVE

() is an opportunistic and nosocomial pathogen with high mortality. And it has intrinsic resistance to a number of antibiotics classes. In this study, we investigated risk factors for death due to bacteremia.

METHODS

A retrospective cohort study was conducted at a tertiary-care hospital in Beijing, China. The patients from the hospital database with bacteremia between January 2011 and December 2020 were investigated. Univariate and multivariate analyses were performed to identify factors associated with mortality.

RESULTS

51 patients with bacteremia were identified. The mortality rate was 37.3%. Based on the univariate analysis, pulmonary disease (=0.019), chronic kidney disease (=0.014), shock (=0.002), foley catheter (=0.011), the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (<0.001), procalcitonin (PCT) (=0.045) and using antifungal agent (=0.033) were significantly related to mortality. Based on the multivariate analysis, the APACHE II score (odds ratio [OR] =1.211; 95% confidence interval [CI]: 1.061, 1.382; =0.005) was independent factor associated with mortality. was the most susceptible to minocycline (94.7%), followed by trimethoprim and sulfamethoxazole (TMP/SMX, 92.2%).

CONCLUSION

Our findings suggested that the APACHE II score was a significantly independent predictor in bacteremia patients. The use of TMP/SMX or minocycline might be the first choice for the treatment of bacteremia.

摘要

目的

(某病原体名称)是一种具有高死亡率的机会性和医院感染病原体。它对多种抗生素类别具有内在抗性。在本研究中,我们调查了因该菌血症导致死亡的危险因素。

方法

在中国北京的一家三级医院进行了一项回顾性队列研究。对2011年1月至2020年12月期间医院数据库中患有该菌血症的患者进行了调查。进行单因素和多因素分析以确定与死亡率相关的因素。

结果

共识别出51例患有该菌血症的患者。死亡率为37.3%。基于单因素分析,肺部疾病(P = 0.019)、慢性肾脏病(P = 0.014)、休克(P = 0.002)、导尿管(P = 0.011)、急性生理与慢性健康状况评分II(APACHE II)(P < 0.001)、降钙素原(PCT)(P = 0.045)以及使用抗真菌药物(P = 0.033)与死亡率显著相关。基于多因素分析,APACHE II评分(比值比[OR] = 1.211;95%置信区间[CI]:1.061,1.382;P = 0.005)是与死亡率相关的独立因素。该菌对米诺环素最敏感(94.7%),其次是甲氧苄啶磺胺甲恶唑(TMP/SMX,92.2%)。

结论

我们的研究结果表明,APACHE II评分是菌血症患者死亡率的显著独立预测指标。使用TMP/SMX或米诺环素可能是治疗该菌血症的首选。

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