Karruli Arta, Massa Alessia, Bertolino Lorenzo, Andini Roberto, Sansone Pasquale, Dongiovanni Salvatore, Pace Maria Caterina, Pota Vincenzo, Durante-Mangoni Emanuele
Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Via de Crecchio 7, 80138 Napoli, Italy.
Unit of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore Ruggieri, 80131 Napoli, Italy.
Antibiotics (Basel). 2022 Oct 13;11(10):1411. doi: 10.3390/antibiotics11101411.
(1) Background: The aim of this study was to assess the clinical and microbiological characteristics of multidrug-resistant infections in a neuromuscular semi-intensive/sub-intensive care unit; (2) Methods: Retrospective analysis on data from 18 patients with NMD with proven MDRO/XDRO colonisation/infection from August 2021 to March 2022 was carried out; (3) Results: Ten patients were males (55.6%), with a median age of 54 years, and there were fourteen patients (77.8%) with amyotrophic lateral sclerosis. All patients had at least one invasive device. Ten (55.6%) patients developed MDRO/XDRO infection (with a median time of 24 days) while six (33.3%) were colonised. The Charlson comorbidity index was >2 in both groups but higher in the infected compared with the colonised (4.5 vs. 3). Infected patients were mostly females (seven patients) with a median age of 62 years. The most common pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa, infecting four (28.6%) patients each. Of eighteen infectious episodes, nine were pneumonia (hospital-acquired in seven cases). Colistin was the most commonly active antibiotic while carbapenems were largely inactive. Eradication of infection occurred in seven infectious episodes (38.9%). None of those with infection died; (4) Conclusions: MDRO/XDRO infections are common in patients with neuromuscular diseases, with carbapenem-resistant non-fermenting Gram-negative bacilli prevailing. These infections were numerically associated with the female sex, greater age, and comorbidities. Both eradication and infection-related mortality appeared low. We highlight the importance of infection prevention in this vulnerable population.
(1) 背景：本研究旨在评估神经肌肉半强化/强化护理病房中多重耐药感染的临床和微生物学特征；(2) 方法：对2021年8月至2022年3月期间18例确诊为多重耐药菌/广泛耐药菌定植/感染的神经肌肉疾病患者的数据进行回顾性分析；(3) 结果：10例患者为男性（55.6%），中位年龄54岁，14例患者（77.8%）患有肌萎缩侧索硬化症。所有患者至少有一个侵入性装置。10例（55.6%）患者发生多重耐药菌/广泛耐药菌感染（中位时间为24天），6例（33.3%）为定植。两组患者的Charlson合并症指数均>2，但感染组高于定植组（4.5比3）。感染患者大多为女性（7例），中位年龄62岁。最常见的病原体是鲍曼不动杆菌和铜绿假单胞菌，各感染4例（28.6%）患者。在18次感染发作中，9次为肺炎（7例为医院获得性）。黏菌素是最常用的有效抗生素，而碳青霉烯类药物大多无效。7次感染发作（38.9%）的感染得到根除。感染患者均未死亡；(4) 结论：多重耐药菌/广泛耐药菌感染在神经肌肉疾病患者中很常见，以耐碳青霉烯类非发酵革兰阴性杆菌为主。这些感染在数量上与女性、年龄较大和合并症有关。根除率和感染相关死亡率似乎都很低。我们强调了在这一脆弱人群中预防感染的重要性。
