Sadyrbaeva-Dolgova Svetlana, Sánchez-Suárez María Del Mar, Reguera Márquez Juan Antonio, Hidalgo-Tenorio Carmen
Pharmacy Service, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain.
Instituto de Investigación Biosanitaria ibs.GRANADA, 18014 Granada, Spain.
Microorganisms. 2023 Mar 30;11(4):899. doi: 10.3390/microorganisms11040899.
Nosocomial infections caused by non-fermenting Gram-negative bacteria are a real challenge for clinicians, especially concerning the accuracy of empirical treatment. This study aimed to describe the clinical characteristic, empirical antibiotic therapy, accuracy of these prescriptions for appropriate coverage and risk factor for clinical failure of bloodstream infections due to non-fermenting Gram-negative bacilli. This retrospective, observational cohort study was conducted between January 2016 and June 2022. Data were collected from the hospital's electronic record. The statistic tests corresponding to each objective were applied. A multivariate logistic regression was performed. Among the total 120 patients included in the study, the median age was 63.7 years, and 79.2% were men. Considering the appropriate empirical treatment rate by species, inappropriate treatment for was 72.4% ( = 0.088), for 67.6% and 45.6% for . Clinical success was achieved in 53.3%, and overall, 28-day mortality was 45.8%. ICU admission, sepsis or shock septic, age, previous antibiotic treatment and contact with healthcare facilities were independently associated with clinical failure. In conclusion, bloodstream infection produced by multidrug-resistant non-fermenting Gram-negative bacteria is a significant therapeutic management challenge for clinicians. The accuracy of empirical treatment is low due to the fact that it is not recommended to cover these microorganisms empirically, especially and .
由非发酵革兰氏阴性菌引起的医院感染对临床医生来说是一个真正的挑战，尤其是在经验性治疗的准确性方面。本研究旨在描述非发酵革兰氏阴性杆菌引起的血流感染的临床特征、经验性抗生素治疗、这些处方对适当覆盖范围的准确性以及临床失败的危险因素。这项回顾性观察队列研究于2016年1月至2022年6月进行。数据从医院电子记录中收集。应用了与每个目标相对应的统计检验。进行了多变量逻辑回归分析。在纳入研究的120名患者中，年龄中位数为63.7岁，79.2%为男性。按菌种考虑适当的经验性治疗率，[具体菌种1]的不适当治疗率为72.4%（P = 0.088），[具体菌种2]为67.6%，[具体菌种3]为45.6%。临床成功率为53.3%，总体而言，28天死亡率为45.8%。入住重症监护病房、脓毒症或感染性休克、年龄、先前的抗生素治疗以及与医疗机构接触与临床失败独立相关。总之，多重耐药非发酵革兰氏阴性菌引起的血流感染对临床医生来说是一个重大的治疗管理挑战。由于不建议经验性覆盖这些微生物，尤其是[具体菌种1]和[具体菌种2]，经验性治疗的准确性较低。
