Alrahmany Diaa, Omar Ahmed F, Hafez Wael, Albaloshi Sara, Harb Gehan, Ghazi Islam M
Pharmaceutical Care Department, Directorate General of Medical Supplies-MOH, Muscat 112-393, Oman.
General Medicine Department, Suhar Hospital, Suhar 311-49, Oman.
Antibiotics (Basel). 2023 Mar 1;12(3):494. doi: 10.3390/antibiotics12030494.
Disturbances in the count or maturity of blood cells weaken their microbial defensive capacity and render them more susceptible to infections. Glucose-6-phosphate deficient patients are affected by a genetic disease that affects cell integrity with increased liability to infections and death. We aimed to investigate the risk factors for infection mortality in this patient population. We retrospectively examined the records of G6PD adult patients with confirmed infections and collected data related to demographics, infections (pathogens, types, and treatment regimens) in addition to mortality and length of stay outcomes. Data were statistically analyzed using R Programming language to identify contributing factors to mortality and treatment regimens association with outcomes. Records of 202 unique patients over 5 years were included, corresponding to 379 microbiologically and clinically confirmed infections. Patients > 60 years [ = 0.001, OR: 5.6], number of comorbidities 4 (2-5) [ < 0.001, OR: 1.8], patients needed blood transfusion [ = 0.003, OR: 4.3]. Respiratory tract infections [ = 0.037, OR: 2.28], HAIs [ = 0.002, OR: 3.9], polymicrobial infections [ = 0.001, OR: 10.9], and concurrent infection Gram-negative [ < 0.001, OR: 7.1] were significant contributors to 28-day mortality. The history of exposure to many antimicrobial classes contributed significantly to deaths, including β-lactam/β-lactamase [ = 0.002, OR: 2.5], macrolides [ = 0.001, OR: 3.34], and β-lactams [ = 0.012, OR: 2.0]. G6PD patients are a unique population that is more vulnerable to infections. Prompt and appropriate antimicrobial therapy is warranted to combat infections. A strict application of stewardship principles (disinfection, shortening the length of stay, and controlling comorbid conditions) may be beneficial for this population. Finally, awareness of the special needs of this patient group may improve treatment outcomes.
血细胞数量或成熟度的紊乱会削弱其微生物防御能力,使其更容易受到感染。葡萄糖-6-磷酸缺乏症患者患有一种影响细胞完整性的遗传疾病,感染和死亡风险增加。我们旨在调查该患者群体感染死亡率的危险因素。我们回顾性检查了确诊感染的G6PD成年患者的记录,并收集了除死亡率和住院时间结果外的人口统计学、感染(病原体、类型和治疗方案)相关数据。使用R编程语言对数据进行统计分析,以确定导致死亡的因素以及治疗方案与结果的关联。纳入了5年期间202例独特患者的记录,对应379例微生物学和临床确诊感染。年龄>60岁[ = 0.001,OR:5.6]、合并症数量为4(2 - 5)[ < 0.001,OR:1.8]、需要输血的患者[ = 0.003,OR:4.3]。呼吸道感染[ = 0.037,OR:2.28]、医院获得性感染[ = 0.002,OR:3.9]、多重微生物感染[ = 0.001,OR:10.9]以及合并革兰氏阴性菌感染[ < 0.001,OR:7.1]是28天死亡率的重要因素。接触多种抗菌药物类别史对死亡有显著影响,包括β-内酰胺/β-内酰胺酶抑制剂[ = 0.002,OR:2.5]、大环内酯类[ = 0.001,OR:3.34]和β-内酰胺类[ = 0.012,OR:2.0]。G6PD患者是一个更容易感染的独特群体。需要及时、适当的抗菌治疗来对抗感染。严格应用管理原则(消毒、缩短住院时间和控制合并症)可能对该群体有益。最后,了解该患者群体的特殊需求可能会改善治疗结果。