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血流感染是一种普遍的社区获得性疾病,具有重要的死亡率:来自澳大利亚回顾性观察研究的结果。

bloodstream infection is a prevailing community-onset disease with important mortality rates: results from a retrospective observational study in Australia.

机构信息

Department of Infectious Diseases, Hospital del Mar, Hospital del Mar Research Institute (IMIM), Universitat Pompeu Fabra (UPF), Barcelona, Spain.

CIBERINFEC, ISCIII - CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Infect Dis (Lond). 2024 Aug;56(8):606-615. doi: 10.1080/23744235.2024.2333979. Epub 2024 Mar 27.

Abstract

BACKGROUND

The recognition of i as a cause of infections in humans has been increasing. However, only case reports and small series of bloodstream infections have been published. Epidemiological data on these infections are extremely scarce. Our objective was to describe the incidence, epidemiology, antimicrobial resistance rates, and outcomes of bloodstream infections in a large population-based cohort in Australia.

METHODS

Retrospective, laboratory-based surveillance study conducted in Queensland, Australia (population ≈ 5 million) during 2000-2019. Clinical information was obtained from public hospital admissions and vital statistics databases.

RESULTS

In total, 228 episodes of bloodstream infections were identified. Increased incidence was observed in the later years, especially in older men, and was higher during the rainy months of the year and in the warmest and more humid regions of the state. The majority of bloodstream infections were community-onset with 120 (52.6%) community-associated and 59 (25.9%) ambulatory healthcare-associated episodes. Only 49 cases (21.5%) were nosocomial. The most common foci of infection were skin and soft tissue, lower respiratory tract, and intra-abdominal. No isolate showed antimicrobial resistance. Thirty-one patients (13.6%) died. The mortality rate in patients with a respiratory infectious source was higher (21%).

CONCLUSIONS

bloodstream infection was predominantly a community-onset condition including ambulatory healthcare related cases, with increasing incidence, especially in older males. No antimicrobial resistance was observed. Mortality was high in patients with respiratory infectious source. This new observational data have implications when considering the epidemiology of these infections and for patient management.

摘要

背景

人们对 i 作为人类感染源的认识不断提高。然而,目前仅发表了一些关于血流感染的病例报告和小系列研究。关于这些感染的流行病学数据极其匮乏。我们的目的是描述澳大利亚一个大型基于人群的队列中血流感染的发生率、流行病学、抗微生物药物耐药率和结局。

方法

这是一项在澳大利亚昆士兰州(人口约 500 万)进行的回顾性、基于实验室的监测研究,时间为 2000 年至 2019 年。临床信息来自公立医院入院和生命统计数据库。

结果

共确定了 228 例血流感染病例。发病率在后期有所增加,尤其是老年男性,且在一年中雨季以及该州较温暖和潮湿的地区发病率更高。大多数血流感染为社区发病,其中 120 例(52.6%)为社区相关,59 例(25.9%)为门诊医疗保健相关。仅有 49 例(21.5%)为医院获得性。最常见的感染部位为皮肤和软组织、下呼吸道和腹腔内。没有分离株显示出抗微生物药物耐药性。31 例患者(13.6%)死亡。有呼吸道感染源的患者死亡率更高(21%)。

结论

血流感染主要是社区发病,包括与门诊医疗保健相关的病例,发病率不断上升,尤其是老年男性。未观察到抗微生物药物耐药性。有呼吸道感染源的患者死亡率较高。这些新的观察数据对考虑这些感染的流行病学和患者管理具有重要意义。

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