Department of Internal Medicine, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, 1102, Lebanon.
Division of Infectious Diseases, Department of Internal Medicine, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, 1102, Lebanon.
Ann Clin Microbiol Antimicrob. 2024 Oct 9;23(1):90. doi: 10.1186/s12941-024-00740-0.
Gram-negative bacteremia is a life-threatening infection with high morbidity and mortality. Its incidence is rising worldwide, and treatment has become more challenging due to emerging bacterial resistance. Little data is available on the burden and outcome of such infections in Lebanon.
We conducted this retrospective study in four Lebanese hospitals. Data on medical conditions and demographics of 2400 patients diagnosed with a bloodstream infection based on a positive blood culture were collected between January 2014 and December 2020.
Most bacteremias were caused by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, with the more resistant organisms being hospital-acquired. Third-generation cephalosporin and quinolone resistance was steady throughout the study, but carbapenem resistance increased. Mortality with such infections is high, but carbapenem resistance or infection with Pseudomonas or Acinetobacter species were significant risk factors for poor outcomes.
This is the first multi-center study from Lebanon on gram-negative bacteremia, resistance patterns, and factors associated with a poor outcome. More surveillance is needed to provide data to guide empirical treatment for bacteremia in Lebanon.
革兰氏阴性菌血症是一种具有高发病率和死亡率的危及生命的感染。其发病率在全球范围内呈上升趋势，由于新出现的细菌耐药性，治疗变得更加具有挑战性。关于黎巴嫩此类感染的负担和结果的数据很少。
我们在四家黎巴嫩医院进行了这项回顾性研究。2014 年 1 月至 2020 年 12 月期间，收集了 2400 名基于阳性血培养诊断为血流感染的患者的医疗状况和人口统计学数据。
大多数菌血症是由大肠杆菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌引起的，而更耐药的细菌是医院获得性的。整个研究期间，第三代头孢菌素和喹诺酮类药物的耐药率保持稳定，但碳青霉烯类药物的耐药率增加。此类感染的死亡率很高，但碳青霉烯类耐药或感染铜绿假单胞菌或鲍曼不动杆菌是预后不良的显著危险因素。
这是黎巴嫩首例关于革兰氏阴性菌血症、耐药模式和不良预后相关因素的多中心研究。需要进行更多的监测，以提供数据来指导黎巴嫩菌血症的经验性治疗。
