新型冠状病毒肺炎住院患者发生医院获得性血流感染叠加的危险因素

Risk Factor for Superimposed Nosocomial Bloodstream Infections in Hospitalized Patients with COVID-19.

作者信息

Sathaporn Natthaka, Khwannimit Bodin

机构信息

Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.

出版信息

Infect Drug Resist. 2023 Jun 13;16:3751-3759. doi: 10.2147/IDR.S411830. eCollection 2023.

DOI:10.2147/IDR.S411830

PMID:37333683

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10276631/

Abstract

INTRODUCTION

Corticosteroids are a component of the standard therapy for patients with coronavirus disease 2019 (COVID-19) because of the immunological dysregulation and hyperinflammation associated with the condition. This study aimed to evaluate the potential risk factors for nosocomial bloodstream infections in hospitalized patients with COVID-19, including the exploration of corticosteroid dosage and treatment duration.

MATERIALS AND METHODS

A retrospective cohort study of hospitalized patients with COVID-19 was conducted in a tertiary care hospital. We performed univariate and multivariate analyses of various parameters to identify risk factors for nosocomial bloodstream infection.

RESULTS

Of 252 patients, 19% had nosocomial bloodstream infections. The mortality rate of nosocomial bloodstream infections was 62.5%. Multivariate analysis revealed that male sex (odds ratio [OR] 3.43; 95% confidence interval [CI]: 1.60-7.33), receiving methylprednisolone (OR: 3.01; 95% CI: 1.24-7.31), receiving an equivalent dexamethasone dose of 6-12 mg/day (OR: 7.49; 95% CI: 2.08-26.94), and leukocytosis on admission (OR: 4.13; 95% CI: 1.89-9.01) were significant predictors of nosocomial bloodstream infections.

CONCLUSION

Unmodified risk variables for nosocomial bloodstream infections included male sex and leukocytosis at admission. Using methylprednisolone and obtaining a cumulative dosage of dexamethasone were adjusted risk variables associated with superimposed nosocomial bloodstream infections in hospitalized patients with COVID-19.

摘要

引言

由于2019冠状病毒病（COVID-19）患者存在免疫失调和炎症反应过度，皮质类固醇是其标准治疗的组成部分。本研究旨在评估COVID-19住院患者发生医院血流感染的潜在危险因素，包括探索皮质类固醇的剂量和治疗持续时间。

材料与方法

在一家三级护理医院对COVID-19住院患者进行了一项回顾性队列研究。我们对各种参数进行了单变量和多变量分析，以确定医院血流感染的危险因素。

结果

252例患者中，19%发生了医院血流感染。医院血流感染的死亡率为62.5%。多变量分析显示，男性（比值比[OR]3.43；95%置信区间[CI]：1.60-7.33）、接受甲泼尼龙治疗（OR：3.01；95%CI：1.24-7.31）、接受相当于地塞米松剂量6-12mg/天的治疗（OR：7.49；95%CI：2.08-26.94）以及入院时白细胞增多（OR：4.13；95%CI：1.89-9.01）是医院血流感染的显著预测因素。