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世界卫生组织重点病原体血流感染患者30天死亡率的预测因素:来自印度中部一家转诊教学医院的单中心探索性研究

Predictors of thirty-day mortality among patients with blood stream infection with WHO priority pathogens: single centre exploratory study from a referral teaching hospital in central India.

作者信息

Budhiraja Akshit, Karuna Tadepalli, Khan Farhan, Kumar Shweta, Shaji Namitha, Bajaj Ehsaas, Purwar Shashank, Pakhare Abhijit, Joshi Rajnish, Saigal Saurabh, Khadanga Sagar

机构信息

Department of General Medicine, AIIMS Bhopal, Saket Nagar, Bhopal, India.

Department of Microbiology, AIIMS Bhopal, Saket Nagar, Bhopal, India.

出版信息

Iran J Microbiol. 2024 Jun;16(3):285-292. doi: 10.18502/ijm.v16i3.15748.

Abstract

BACKGROUND AND OBJECTIVES

Bloodstream infection (BSI) is defined by the presence of viable microorganisms in the bloodstream. BSI is one of the major causes of sepsis and subsequent adverse clinical outcomes all across the globe. The present study was undertaken to identify clinico-epidemio-microbiological variables associated with 30-day mortality in patients having BSI with WHO priority pathogens.

MATERIALS AND METHODS

The study was conducted at a public sector tertiary care institute in central India from April 2019 to March 2021. Blood samples collected from patients with clinical suspicion of sepsis, were processed by automated bacterial culture system and interpreted as per CLSI guidelines. Calculated sample size was 150. Data was analyzed by R software.

RESULTS

Respiratory tract infection was the most common source (43.3%) of BSI, followed by the gastrointestinal (20%) and urinary tract (18.7%). Among the patients, 33% required invasive mechanical ventilation, and 31% required inotropes. Diabetes mellitus (DM) was the most common co-morbidity (34%). The incidence of multi-drug resistant organisms (MDRO) was 59.3%. was the most commonly (24%) isolated organism, followed by (17.3%) and (16%).

CONCLUSION

Higher age, higher qSOFA score / SIRS score / mean SOFA score at presentation had higher mortality. Use of mechanical ventilation and inotropes during treatment and isolation of critical category organisms of WPP and multi drug resistant organisms were independent 30-day mortality predictors.

摘要

背景与目的

血流感染(BSI)定义为血流中存在活的微生物。BSI是全球脓毒症及后续不良临床结局的主要原因之一。本研究旨在确定与感染世界卫生组织重点病原体的BSI患者30天死亡率相关的临床 - 流行病学 - 微生物学变量。

材料与方法

该研究于2019年4月至2021年3月在印度中部的一家公立三级医疗机构进行。从临床怀疑患有脓毒症的患者采集的血样,通过自动细菌培养系统进行处理,并根据CLSI指南进行解读。计算得出的样本量为150。数据采用R软件进行分析。

结果

呼吸道感染是BSI最常见的来源(43.3%),其次是胃肠道(20%)和泌尿道(18.7%)。在患者中,33%需要有创机械通气,31%需要使用血管活性药物。糖尿病(DM)是最常见的合并症(34%)。多重耐药菌(MDRO)的发生率为59.3%。 是最常分离出的微生物(24%),其次是 (17.3%)和 (16%)。

结论

年龄较大、就诊时较高的qSOFA评分/SIRS评分/平均SOFA评分有较高的死亡率。治疗期间使用机械通气和血管活性药物以及分离出世界卫生组织重点病原体中的关键类别微生物和多重耐药菌是30天死亡率的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bbc/11245355/d2c74643a36e/IJM-16-285-g001.jpg

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