希腊高危患者中多重耐药菌的直肠定植与血流感染风险
Rectal colonization with multidrug-resistant organisms and risk for bloodstream infection among high-risk Greek patients.
作者信息
Karakosta Polyxeni, Meletis Georgios, Kousouli Elisavet, Protonotariou Efthymia, Tarpatzi Aikaterini, Vourli Sophia, Georgiou Panagiota Christina, Mamali Vasiliki, Skoura Lemonia, Zarkotou Olympia, Pournaras Spyros
机构信息
Laboratory of Clinical Microbiology, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Microbiology, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
出版信息
Eur J Clin Microbiol Infect Dis. 2025 Feb;44(2):437-442. doi: 10.1007/s10096-024-04987-5. Epub 2024 Nov 21.
BACKGROUND
Studies link multidrug-resistant organism (MDRO) rectal colonization to increased infection risk, data from Greece, a country with high rates of MDRO, are limited.
METHODS
We assessed bloodstream infection (BSI) risk following rectal colonization by MDROs across three Greek hospitals (2019-2022).
RESULTS
Of 4,370 inpatients, 31.1% were colonized by carbapenem-resistant Enterobacterales (CRE), 30.1% carbapenem-resistant Acinetobacter baumannii (CRAB), 5.8% carbapenem-resistant Pseudomonas aeruginosa (CRPA), 28.4% vancomycin-resistant enterococci (VRE). Subsequent BSI from the same MDRO species was developed in 15.6% of CRE, 19.7% of CRAB, 9.2% of CRPA and 3.5% of VRE carriers. Previous rectal colonization increases significantly MDRO BSI risk [RR (95%CI): CRE 5.2 (3.9-6.8), CRAB 2.7 (2.2-3.3), CRPA 9.6 (5.8-16.0), VRE 2.5 (1.5-4.2)].
CONCLUSION
Clinicians should consider MDRO carriage information for selecting empiric treatment.
背景
研究将多重耐药菌（MDRO）直肠定植与感染风险增加联系起来，但来自多重耐药菌感染率较高的希腊的数据有限。
方法
我们评估了希腊三家医院（2019 - 2022年）中MDRO直肠定植后的血流感染（BSI）风险。
结果
在4370名住院患者中，31.1%被耐碳青霉烯类肠杆菌科细菌（CRE）定植，30.1%被耐碳青霉烯类鲍曼不动杆菌（CRAB）定植，5.8%被耐碳青霉烯类铜绿假单胞菌（CRPA）定植，28.4%被耐万古霉素肠球菌（VRE）定植。随后，15.6%的CRE携带者、19.7%的CRAB携带者、9.2%的CRPA携带者和3.5%的VRE携带者发生了来自同一MDRO菌种的BSI。既往直肠定植显著增加了MDRO导致BSI的风险[相对风险（95%置信区间）：CRE为5.2（3.9 - 6.8），CRAB为2.7（2.2 - 3.3），CRPA为9.6（5.8 - 16.0），VRE为2.5（1.5 - 4.2）]。
结论
临床医生在选择经验性治疗时应考虑MDRO携带情况信息。
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