Goeijenbier M, van der Bie S, Souverein D, Bolluyt D, Nagel M, Stoof S P, Vermin B, Weenink J, van Gorp E C M, Euser S, Kalpoe J, van Houten M A, Endeman H, Gommers D, Haas L E M, van Lelyveld S F L
Department of Intensive Care Medicine, Spaarne Gasthuis, 2035 RC Haarlem, The Netherlands.
Department of Intensive Care Medicine, Erasmus MC University Medical Centre, 3015 GD Rotterdam, The Netherlands.
J Clin Med. 2024 Jun 12;13(12):3443. doi: 10.3390/jcm13123443.
: () infections can progress to severe respiratory complications, necessitating intensive care treatment. Recent post COVID-19 pandemic surges underscore the need for timely diagnosis, given potential diagnostic method limitations. A retrospective case series analysis was conducted on PCR-positive patients admitted to two Dutch secondary hospitals' ICUs between January 2023 and February 2024. Clinical presentations, treatments, outcomes, and mechanical ventilation data were assessed. : Seventeen ICU-admitted patients were identified, with a median age of 44 years, primarily due to hypoxia. Non-invasive ventilation was effective for most, while five required invasive mechanical ventilation. None of the patients required extracorporeal membrane oxygenation. No fatalities occurred. Post-PCR, treatment was adjusted to doxycycline or azithromycin; seven received steroid treatment. : Increased ICU admissions for infection were observed. Diverse clinical and radiological findings emphasize heightened clinical awareness. Early molecular diagnostics and tailored antibiotic regimens are crucial since beta-lactam antibiotics are ineffective. : This study highlights the escalating challenge of severe infections in ICUs, necessitating a multifaceted approach involving accurate diagnostics, vigilant monitoring, and adaptable treatment strategies for optimal patient outcomes.
（）感染可进展为严重的呼吸并发症，需要重症监护治疗。鉴于潜在的诊断方法局限性，近期新冠疫情后的感染激增凸显了及时诊断的必要性。对2023年1月至2024年2月期间入住荷兰两家二级医院重症监护病房的PCR检测呈阳性的患者进行了一项回顾性病例系列分析。评估了临床表现、治疗、结局和机械通气数据。：确定了17名入住重症监护病房的患者，中位年龄为44岁，主要原因是缺氧。无创通气对大多数患者有效，而5名患者需要有创机械通气。没有患者需要体外膜肺氧合。没有发生死亡病例。PCR检测后，治疗调整为使用强力霉素或阿奇霉素；7名患者接受了类固醇治疗。：观察到因（）感染而入住重症监护病房的人数增加。多样的临床和影像学表现强调了提高临床意识的重要性。由于β-内酰胺类抗生素无效，早期分子诊断和定制的抗生素治疗方案至关重要。：本研究强调了重症监护病房中严重（）感染不断升级的挑战，需要采取多方面的方法，包括准确诊断、密切监测和适应性治疗策略，以实现最佳的患者结局。
