Pan Deng, Peng Pin, Fang Yu, Lu Jun, Fang Minghao
Department of Infectious Disease, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei, People's Republic of China.
Intensive Care Unit, Wuhan Asia General Hospital, Wuhan, Hubei, People's Republic of China.
Infect Drug Resist. 2022 Jul 28;15:4109-4116. doi: 10.2147/IDR.S373665. eCollection 2022.
The aim of this study was to investigate the distribution and drug resistance of pathogenic bacteria and the prognosis of patients with sepsis bloodstream infection with renal insufficiency.
One hundred and twelve patients with septicemic bloodstream infection with renal insufficiency and 112 patients with septic bloodstream infection without renal insufficiency were selected as study group and control group, respectively. We compare the distribution of pathogenic bacteria, analyze the drug resistance of major bacteria, and compare the efficacy, the incidence of septic shock, duration of mechanical ventilation, hospitalization time, and duration of antimicrobial drug administration between the two groups.
A total of 140 pathogenic strains were isolated from blood cultures in the study group, and 136 strains were isolated from blood cultures in the control group. The sepsis bloodstream infection was mainly caused by Gram-negative bacteria, accounting for 59.42% (164/276). Among the gram-negative bacteria, , and had higher resistance rates to levofloxacin, ceftazidime, piperacillin sodium tazobactam, and amikacin. Among the gram-positive bacteria, , and had high resistance rates to clindamycin, cefazolin, penicillin G, gentamicin, azithromycin, and levofloxacin. The rate of extended spectrum β-lactamase (ESBLs)-producing enterobacteria and multi-drug resistant (MDR-PA) infection was significantly higher in the study group than in the control group; there was no difference in multi-drug resistant (MDR-AB), vancomycin-resistant (VRE), and methicillin-resistant (MRSA) between the two groups. The duration of hospitalization and the duration of antimicrobial drug administration were longer in the study group than in the control group.
The pathogenic bacteria in patients with sepsis bloodstream infection with renal insufficiency are mainly Gram-negative bacteria, are more difficult to be cured, have a longer course of treatment, and need to use antibacterial drugs for a long time.
本研究旨在调查病原菌的分布及耐药情况，以及合并肾功能不全的脓毒症血流感染患者的预后。
分别选取112例合并肾功能不全的脓毒症血流感染患者和112例无肾功能不全的脓毒症血流感染患者作为研究组和对照组。比较病原菌的分布情况，分析主要细菌的耐药性，并比较两组的疗效、脓毒性休克发生率、机械通气时间、住院时间及抗菌药物使用时间。
研究组血培养共分离出140株病原菌，对照组血培养分离出136株病原菌。脓毒症血流感染主要由革兰阴性菌引起，占59.42%（164/276）。在革兰阴性菌中，[具体细菌名称1]、[具体细菌名称2]和[具体细菌名称3]对左氧氟沙星、头孢他啶、哌拉西林钠他唑巴坦和阿米卡星的耐药率较高。在革兰阳性菌中，[具体细菌名称4]、[具体细菌名称5]和[具体细菌名称6]对克林霉素、头孢唑林、青霉素G、庆大霉素、阿奇霉素和左氧氟沙星的耐药率较高。研究组产超广谱β-内酰胺酶（ESBLs）肠杆菌和多重耐药鲍曼不动杆菌（MDR-PA）感染率显著高于对照组；两组多重耐药铜绿假单胞菌（MDR-AB）、耐万古霉素肠球菌（VRE）和耐甲氧西林金黄色葡萄球菌（MRSA）感染率差异无统计学意义。研究组住院时间和抗菌药物使用时间均长于对照组。
合并肾功能不全的脓毒症血流感染患者病原菌以革兰阴性菌为主，较难治愈，疗程较长，需长期使用抗菌药物。
