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黏液型与非黏液型感染的抗生素药敏模式和临床特征的对比分析:一项回顾性研究。

Comparative analysis of antibiotic susceptibility patterns and clinical features of mucoid and non-mucoid infections: a retrospective study.

机构信息

Medical Laboratory Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.

General Medicine, Clinical Medicine, Kangda College of Nanjing Medical University, Lianyungang, Jiangsu, China.

出版信息

Front Public Health. 2024 Feb 8;12:1333477. doi: 10.3389/fpubh.2024.1333477. eCollection 2024.

Abstract

BACKGROUND

(PA) is a prevalent opportunistic pathogen that has close associations with both acute and chronic infections. However, there exists an insufficiency of accurate and comprehensive data pertaining to the antimicrobial susceptibility patterns and clinical characteristics of both mucoid and non-mucoid strains of PA (mPA and non-mPA, respectively).

METHODS

From January 1, 2021 to December 31, 2022, a thorough retrospective study was carried out to examine and compare the antibiotic susceptibility test outcomes and clinical characteristics of hospitalized patients with mPA and non-mPA infections.

RESULTS

This study investigated a cohort of 111 patients who were diagnosed with mPA infections, as well as 792 patients diagnosed with non-mPA infections. Significant demographic disparities, including gender ( < 0.001), age ( < 0.001), length of hospital stay ( < 0.001), diabetes ( = 0.043), and hypertension ( < 0.001), are evident between the mPA and non-mPA groups. The mPA group commonly necessitates hospitalization for respiratory system diseases, whereas the non-mPA group is associated with concomitant cardiovascular and cerebrovascular diseases. The mPA group demonstrates lower utilization rates of medical devices, such as Foley catheter ( < 0.001), nasogastric tube ( < 0.001), mechanical ventilation ( < 0.001), tracheostomy ( < 0.001), arterial and venous catheterization ( < 0.001), and exhibits superior organ function status, including lower incidences of hypoalbuminemia ( < 0.001), septic shock ( < 0.001), liver dysfunction ( < 0.001), renal failure ( < 0.001), and respiratory failure ( < 0.001). The non-mPA group is more vulnerable to infection with two or more bacterial pathogens compared to the mPA group, with the non-mPA group frequently resulting in Enterobacteriaceae infections and the mPA group being associated with fungal infections. Variations in antibiotic sensitivity are noted for Amikacin ( < 0.001), Ciprofloxacin ( < 0.001), Cefepime ( = 0.003), and Levofloxacin ( < 0.001) in antibiotic susceptibility testing, with resistance patterns closely tied to specific antibiotic usage.

CONCLUSION

There are significant demographic characteristics, clinical manifestations and antibiotic susceptibility between mPA and non-mPA infections. It is crucial to emphasize these characteristics due to their significant role in preventing and treating PA infections.

摘要

背景

(PA)是一种普遍存在的机会性病原体,与急性和慢性感染都有密切关联。然而,目前关于粘液化和非粘液化 PA(mPA 和非-mPA,分别)的药敏模式和临床特征的准确、全面的数据仍然不足。

方法

本研究于 2021 年 1 月 1 日至 2022 年 12 月 31 日进行了一项全面的回顾性研究,以检查和比较住院患者 mPA 和非-mPA 感染的抗生素敏感性试验结果和临床特征。

结果

本研究共调查了 111 例 mPA 感染患者和 792 例非-mPA 感染患者。两组患者在性别(<0.001)、年龄(<0.001)、住院时间(<0.001)、糖尿病(=0.043)和高血压(<0.001)等方面存在显著的人口统计学差异。mPA 组常见的住院治疗原因是呼吸系统疾病,而非-mPA 组则与心血管和脑血管疾病并存。mPA 组中 Foley 导管(<0.001)、鼻胃管(<0.001)、机械通气(<0.001)、气管切开术(<0.001)、动静脉置管(<0.001)等医疗器械的使用率较低,器官功能状态较好,低白蛋白血症(<0.001)、感染性休克(<0.001)、肝功能障碍(<0.001)、肾功能衰竭(<0.001)和呼吸衰竭(<0.001)的发生率较低。与 mPA 组相比,非-mPA 组更容易感染两种或两种以上的细菌病原体,非-mPA 组常导致肠杆菌科感染,而 mPA 组与真菌感染有关。在抗生素敏感性试验中,阿米卡星(<0.001)、环丙沙星(<0.001)、头孢吡肟(=0.003)和左氧氟沙星(<0.001)的抗生素敏感性存在差异,耐药模式与特定抗生素的使用密切相关。

结论

mPA 和非-mPA 感染之间存在显著的人口统计学特征、临床表现和抗生素敏感性。由于这些特征在预防和治疗 PA 感染方面具有重要作用,因此必须强调这些特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8023/10881668/76f947b7cb58/fpubh-12-1333477-g001.jpg

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