Ma Ru, Chen Qiang, Huang Ying, Cheng Zhongle, Wang Xiaowei, Xia Lingling, Hu Lifen
Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
Infect Drug Resist. 2023 Jul 24;16:4779-4787. doi: 10.2147/IDR.S417151. eCollection 2023.
The purpose of this study was to analyze the prognosis of patients tested positive for (SMA) from different sources.
A retrospective study was conducted among 651 patients tested positive for SMA from January 2020 to October 2022 in the First Affiliated Hospital of Anhui Medical University. The patients were divided into seven groups by the source of SMA. Univariate and multivariate analyses were used to identify risk factors for mortality in patients tested positive for SMA from different sources.
A total of 651 SMA isolates were collected from various sources, including sputum (348 isolates, 53%), bronchoalveolar lavage fluid (52, 8%), abdominal drainage fluid (76, 12%), wound secretion (66, 10%), blood (62, 10%), urine (41, 6%) and cerebrospinal fluid (6, 1%). Compared with other groups, the mortality of the patients in the bronchoalveolar lavage fluid culture group, blood culture group, and abdominal drainage fluid culture group was higher, at 40.38%, 32.26%, and 26.32%, respectively. Multivariate analysis showed that continuous renal replacement therapy was an independent risk factor for mortality in patients with SMA bloodstream infection (=0.020, OR=6.86), and effective antimicrobial therapy after being positive for isolates (=0.002, OR=0.10) was negatively correlated with the death of patients with SMA bloodstream infection. Age ≥65 years (= 0.043, OR=4.96), kidney disease (=0.045, OR=4.62) and antifungal agent exposure (=0.036, OR=5.13) were independent risk factors for mortality in patients with SMA intra-abdominal infection. Antifungal agent exposure (=0.024, OR=0.51) and glycopeptide exposure (=0.045, OR=0.53) were independent risk factors for mortality in patients in the sputum culture group.
SMA has a high rate of antimicrobial resistance and can cause multisite infection. Pulmonary infections, bloodstream infections and abdominal infections caused by SMA have high mortality, and timely standardized treatment can reduce mortality.
本研究旨在分析不同来源的对（SMA）检测呈阳性患者的预后情况。
对2020年1月至2022年10月在安徽医科大学第一附属医院651例对SMA检测呈阳性的患者进行回顾性研究。根据SMA来源将患者分为七组。采用单因素和多因素分析确定不同来源的SMA检测呈阳性患者死亡的危险因素。
共从各种来源收集到651株SMA分离株，包括痰液（348株，53%）、支气管肺泡灌洗液（52株，8%）、腹腔引流液（76株，12%）、伤口分泌物（66株，10%）、血液（62株，10%）、尿液（41株，6%）和脑脊液（6株，1%）。与其他组相比，支气管肺泡灌洗液培养组、血培养组和腹腔引流液培养组患者的死亡率较高，分别为40.38%、32.26%和26.32%。多因素分析显示，持续肾脏替代治疗是SMA血流感染患者死亡的独立危险因素（=0.020，OR=6.86），而分离株检测呈阳性后有效的抗菌治疗（=0.002，OR=0.10）与SMA血流感染患者的死亡呈负相关。年龄≥65岁（=0.043，OR=
