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中国广州 COVID-19 大流行前后呼吸内科住院患者细菌感染的分布及耐药性

Distribution and Drug Resistance of Bacterial Infection in Hospitalized Patients at the Respiratory Department before and after the COVID-19 Pandemic in Guangzhou, China.

作者信息

Hao Ling, Yang Xiao, Chen Huiling, Wei Shuquan, Xu Banglao, Zhao Ziwen

机构信息

Department of Pulmonary and Critical Care Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China.

Department of Laboratory Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou 510180, China.

出版信息

Microorganisms. 2023 Oct 12;11(10):2542. doi: 10.3390/microorganisms11102542.

Abstract

Since COVID-19 might have a lasting impact on global public health, it is crucial to analyze its effect on drug-resistant bacterial infections in the respiratory system for the prevention and control of hospital infections. This work aimed to investigate the impact of the COVID-19 outbreak on the clinical distribution and antibiotic resistance of bacterial infection among hospitalized patients in the respiratory unit in order to establish strategies to control antibiotic-resistant infections. Electronic clinical data registry records from 2018 to 2022 were retrospectively analyzed. A total of 36,829 clinical specimens, including sputum, bronchoalveolar lavage fluid, blood, and urine, were collected from 16,073 patients admitted to the Guangzhou First People's Hospital from January 2018 to December 2022. Among them, 2209 samples were culture-positive. The bacterial isolation rates of different types of samples showed a similar trend from 2019 to 2022, with an increase in 2020 and 2022 and a decrease in 2021. Different bacterial species were separated from different types of samples. The most reported pathogens were identified in sputum samples. Gram-positive isolates were prevalent in urine samples, while Gram-negative bacilli were the predominant pathogenic bacteria isolated from respiratory tract and blood samples. (), () complex, and () were the most abundant Gram-negative bacteria in sputum samples, of which complex had the highest resistance to all tested antibiotics except colistin. Notably, there has been a substantial prevalence of carbapenem-resistant , , and in the past five years. This alarming situation calls for greater attention and precaution with prescribed antibiotics to limit the generation and spread of new multidrug-resistant bacteria and improve therapeutic management.

摘要

由于新型冠状病毒肺炎(COVID-19)可能对全球公共卫生产生持久影响,分析其对呼吸系统耐药细菌感染的影响对于医院感染的预防和控制至关重要。这项工作旨在调查COVID-19疫情对呼吸科住院患者细菌感染的临床分布和抗生素耐药性的影响,以便制定控制耐药感染的策略。对2018年至2022年的电子临床数据登记记录进行了回顾性分析。2018年1月至2022年12月期间,从广州市第一人民医院收治的16073例患者中收集了总共36829份临床标本,包括痰液、支气管肺泡灌洗液、血液和尿液。其中,2209份样本培养呈阳性。2019年至2022年不同类型样本的细菌分离率呈现相似趋势,2020年和2022年有所上升,2021年有所下降。从不同类型的样本中分离出不同的细菌种类。痰液样本中报告最多的病原体被鉴定出来。革兰氏阳性菌在尿液样本中普遍存在,而革兰氏阴性杆菌是从呼吸道和血液样本中分离出的主要病原菌。()、()菌属复合体和()是痰液样本中最丰富的革兰氏阴性菌,其中菌属复合体对除黏菌素外的所有测试抗生素耐药性最高。值得注意的是,在过去五年中,耐碳青霉烯类的()、()和()大量流行。这种令人担忧的情况需要在使用抗生素时给予更多关注和预防,以限制新的多重耐药菌的产生和传播,并改善治疗管理。

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