伊朗碳青霉烯类耐药菌感染住院患者的死亡危险因素。
Risk factors for mortality in hospitalized patients infected with carbapenem-resistant in Iran.
作者信息
Khalili Younes, Omidnia Pooya, Goli Hamid Reza, Zamanlou Sajjad, Babaie Farhad, Bialvaei Abed Zahedi
机构信息
PhD, Iranian Social Security Organization, Molavi Ave., Imam Reza Hospital, Urmia, Iran and Immunology Research Center, Tabriz University of Medical Sciences, Golgasht Street, Tabriz, Iran.
MD, Iranian Social Security Organization, Molavi Ave., Imam Reza Hospital, Urmia, Iran.
出版信息
Germs. 2022 Sep 30;12(3):344-351. doi: 10.18683/germs.2022.1338. eCollection 2022 Sep.
INTRODUCTION
Mortality due to carbapenem-resistant (CRPA) infection has increased worldwide in recent years. The risk factors associated with hospital settings in Iran and the role of strain resistance mechanisms in many studies are unclear.
METHODS
A retrospective study was conducted on consecutive non-repetitive patients with CRPA infections isolated from seven major hospitals from northwest of Iran. We evaluated different risk factors and characteristics of bacteria for the death or survival of patients.
RESULTS
In this study, 116 CRPA isolates were obtained from patients admitted to seven hospitals. Forty-one (35.3%) patients were enrolled in the study of mortality risk factors. Significant risk factors associated with mortality included the site of infection, hospitalization in different wards, the use of invasive devices, and the type of carbapenem resistance mechanisms.
CONCLUSIONS
ICU admission, the use of mechanical ventilation and chest tube and infection with pandrug-resistant strains were the most important factors in increasing mortality due to CRPA infection. These results suggested that the clinicians should emphasize the proper use of antibiotic and invasive procedures.
引言
近年来，耐碳青霉烯类肠杆菌科细菌（CRPA）感染导致的死亡率在全球范围内有所上升。在伊朗，与医院环境相关的风险因素以及许多研究中菌株耐药机制的作用尚不清楚。
方法
对从伊朗西北部七家主要医院分离出的连续非重复CRPA感染患者进行回顾性研究。我们评估了不同的风险因素和细菌特征对患者死亡或存活的影响。
结果
在本研究中，从七家医院收治的患者中获得了116株CRPA分离株。41名（35.3%）患者纳入了死亡风险因素研究。与死亡率相关的显著风险因素包括感染部位、在不同病房住院、使用侵入性设备以及碳青霉烯类耐药机制类型。
结论
入住重症监护病房、使用机械通气和胸管以及感染泛耐药菌株是CRPA感染导致死亡率增加的最重要因素。这些结果表明临床医生应强调抗生素和侵入性操作的合理使用。
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