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中暑危重症患者下呼吸道病原体特征:一项回顾性多中心研究

Characteristics of lower respiratory tract pathogens in critically ill patients with heatstroke: a retrospective multi-center study.

作者信息

Ma Aijia, Jin Xinyang, Wang Yucong, Wang Lietao, Shi Lvyuan, Wan Dingyuan, Wu Qin, He Min, Tang Zhuo, Li Jiajin, Wang Jian, Yang Guangwei, Zhang Zhongwei, Yang Jing, Wang Bo

机构信息

Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China.

School of Pharmacy, Macau University of Science and Technology, Macao, Macao SAR, China.

出版信息

Front Cell Infect Microbiol. 2024 Nov 28;14:1420535. doi: 10.3389/fcimb.2024.1420535. eCollection 2024.

Abstract

This retrospective multicenter study was conducted across 83 intensive care units (ICUs) in 16 cities in Sichuan, China. Critically ill patients diagnosed with heatstroke and lung infections were included in the study. Specimens from the lower respiratory tract were collected for microbiological testing, and the characteristics of the pathogens were described. A total of 462 patients diagnosed with heatstroke-related pulmonary infections were included, 134 patients (29.0%) tested positive for respiratory pathogens. The most frequently isolated strain was (34.3%), followed by (28.4%), (20.9%). The results revealed that in the hyperthermic resistance group, there was a higher proportion of [14(34.1%) vs 11(11.8%), =0.002] and [4(9.8%) vs 1(1.1%), =0.030] compared to the hyperthermic control group. And a higher proportion of [27(29.7%) vs 1(2.3%), <0.001], were obtained during the earlier stages with elevated temperatures. Patients with (38.3 ± 1.9°C), (38.5 ± 2.2°C), and (38.7 ± 1.9°C) exhibited a higher temperature environment. Our study provides crucial insights into the lower respiratory tract pathogenesis of heatstroke patients, identifying key pathogens and their temperature-dependent characteristics, thus providing a foundation for future empirical treatment strategies in heatstroke.

摘要

这项回顾性多中心研究在中国四川省16个城市的83个重症监护病房(ICU)开展。研究纳入了诊断为中暑和肺部感染的重症患者。收集下呼吸道标本进行微生物检测,并描述病原体特征。共纳入462例诊断为中暑相关肺部感染的患者,134例(29.0%)呼吸道病原体检测呈阳性。最常分离出的菌株是 (34.3%),其次是 (28.4%), (20.9%)。结果显示,与高温对照组相比,在高温抵抗组中, [14例(34.1%)对11例(11.8%), =0.002]和 [4例(9.8%)对1例(1.1%), =0.030]的比例更高。在体温升高的早期阶段, [27例(29.7%)对1例(2.3%), <0.001]的比例更高。体温为 (38.3±1.9°C)、 (38.5±2.2°C)和 (38.7±1.9°C)的患者表现出更高的温度环境。我们的研究为中暑患者下呼吸道发病机制提供了关键见解,确定了关键病原体及其温度依赖性特征,从而为未来中暑的经验性治疗策略奠定了基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/582f/11634895/6eb7a512f06b/fcimb-14-1420535-g001.jpg

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