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土耳其埃尔祖鲁姆省恶性肿瘤患者血培养结果评估

Evaluation of Blood Culture Results in Patients with Malignancy in Erzurum Province, Turkey.

作者信息

Aktas Osman, Akbaba Ozgür, Uyanik Muhammet Hamidullah, Uslu Hakan

机构信息

Department of Medical Microbiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey.

出版信息

Acta Med Litu. 2024;31(1):128-139. doi: 10.15388/Amed.2024.31.1.17. Epub 2024 Feb 27.

Abstract

BACKGROUND

Bloodstream infections are a serious public health problem that requires follow-up with blood culture; this negatively affects the course of the disease and patient healthcare costs in patients with malignancy. This study aimed to determine the growth frequency of pathogens and their antibiotic resistance profiles in the blood cultures of patients with hematological and oncogenic malignancies.

MATERIALS AND METHODS

The results of 7451 blood cultures, obtained from 2926 patients between January 2017 and January 2022, were evaluated retrospectively. Of these cultures, 3969 were obtained from patients with malignancy (diagnostic codes C00-D48 in ICD-10) and 3482 from patients without malignancy. The hospital information management system modules were used to acquire patient data and blood culture results.

RESULTS

Various microorganisms grew in 10.1% of blood cultures. Of these organisms, 64.1% were isolated from cases of malignancy. Of the pathogens, 49.2% were gram-negative bacteria, 47.7% were gram-positive bacteria, and 3.1% were fungi. The most frequently isolated bacteria were methicillin-resistant coagulase-negative staphylococci (3.2%), (2.3%), (1.0%), methicillin-sensitive coagulase-negative staphylococci (0.7%), and (0.6%). Pathogen positivity was highest in the patient cultures with urinary system cancer (23.9%), thyroid and other endocrine gland cancers (20.6%), female and male genital organ cancers (18.2%/16.9%), and digestive organ cancer (14.2%). Gram-negative bacteria to ampicillin, piperacillin, and sulfamethoxazole-trimethoprim and Gram-positive bacteria to penicillin, erythromycin, and sulfamethoxazole-trimethoprim were highly resistant. Combined resistance to imipenem and meropenem was observed in 25 Gram-negative bacteria. Twelve (48%) of the carbapenem-resistant bacteria were isolated from patients with lymphoid, hematopoietic, and related tissue malignant neoplasia.

CONCLUSION

This study reported microorganisms and their antimicrobial resistance in the blood cultures of malignant patients, a special patient group. It pointed out that the antibiotic resistance of , and is high enough to cause problems in the treatment of patients with malignancy.

摘要

背景

血流感染是一个严重的公共卫生问题,需要通过血培养进行后续监测;这会对恶性肿瘤患者的疾病进程和医疗费用产生负面影响。本研究旨在确定血液系统和致癌性恶性肿瘤患者血培养中病原体的生长频率及其抗生素耐药谱。

材料与方法

回顾性评估了2017年1月至2022年1月期间从2926例患者中获得的7451份血培养结果。其中,3969份来自恶性肿瘤患者(ICD-10诊断编码C00-D48),3482份来自非恶性肿瘤患者。使用医院信息管理系统模块获取患者数据和血培养结果。

结果

10.1%的血培养中有多种微生物生长。其中,64.1%的微生物分离自恶性肿瘤病例。在病原体中,49.2%为革兰氏阴性菌,47.7%为革兰氏阳性菌,3.1%为真菌。最常分离出的细菌是耐甲氧西林凝固酶阴性葡萄球菌(3.2%)、[此处原文缺失一种细菌名称](2.3%)、[此处原文缺失一种细菌名称](1.0%)、甲氧西林敏感凝固酶阴性葡萄球菌(0.7%)和[此处原文缺失一种细菌名称](0.6%)。泌尿系统癌症患者培养物中的病原体阳性率最高(23.9%),其次是甲状腺及其他内分泌腺癌症(20.6%)、女性和男性生殖器官癌症(18.2%/16.9%)以及消化器官癌症(14.2%)。革兰氏阴性菌对氨苄西林、哌拉西林和磺胺甲恶唑-甲氧苄啶以及革兰氏阳性菌对青霉素、红霉素和磺胺甲恶唑-甲氧苄啶的耐药性较高。在25株革兰氏阴性菌中观察到对亚胺培南和美罗培南的联合耐药性。耐碳青霉烯类细菌中有12株(48%)分离自淋巴、造血及相关组织恶性肿瘤患者。

结论

本研究报告了恶性肿瘤患者这一特殊患者群体血培养中的微生物及其抗菌耐药性。指出[此处原文缺失几种细菌名称]的抗生素耐药性高到足以在恶性肿瘤患者治疗中引发问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49e7/11227679/3613c668c9d5/amed-31-128-g001.jpg

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