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社区获得性多重耐药病原体患者的需氧菌研究、临床谱及转归

Aerobic bacteria study, clinical spectrum, and outcome of patients with community-acquired multidrug-resistant pathogens.

作者信息

Talari Sree Chandra Sekhar, Calerappa Ravi Shankar, Anke Geethanjali

机构信息

Critical Care Medicine, KIMS SAVEERA Hospital, Anantapur, Andhra Pradesh, India.

Consultant Clinical Microbiologist, Department of Laboratory Medicine, KIMS SAVEERA Hospital, Anantapur, Andhra Pradesh, India.

出版信息

J Family Med Prim Care. 2024 Nov;13(11):5052-5059. doi: 10.4103/jfmpc.jfmpc_680_24. Epub 2024 Nov 18.

Abstract

CONTEXT

Infectious diseases are the leading cause of death in developing countries like India. Hence, even small relative increases in the mortality rate for infections due to multidrug-resistant pathogens would lead to substantial increases in the number of deaths as a result of infections worldwide.

AIMS

The aim of the study was to study the microbiological data of community-acquired pathogens and the corresponding outcomes due to antibiotic-resistant versus antibiotic-susceptible bacterial microorganisms.

SETTINGS AND DESIGN

A single-center prospective cohort study for two years undertaken during the study period of March 2022 to 31 October 2023.

MATERIALS AND METHODS

All clinical samples of 402 patients diagnosed microbiologically as community-acquired infections were included. Culture samples were collected and processed according to standard operating procedures and clinical details were recorded.

STATISTICAL ANALYSIS USED

Categorical variables were expressed as counts and percentages. Fisher's exact test was used for testing differences in proportions. Two-sided distribution values of <0.05 were considered significant.

RESULTS

Among Gram-positive organisms, and were predominant isolates. and species were the majority of the pathogens among Gram-negative isolates. Mortality rates observed in community-acquired respiratory tract infections (CA-RTIs), community-acquired urinary tract infections (CA-UTIs), community-acquired skin and soft tissue infections (CA-SSTIs), and community-acquired bloodstream infections (CA-BSIs) were 13.6%, 6.56%, 4.5%, and 31.5%, respectively. The length of hospital stay of more than three days was found as 56.06%, 36.2%, 40.9%, and 73.6% in CA-RTIs, CA-UTIs, CA-SSTIs, and CA-BSIs, respectively.

CONCLUSIONS

Performing cultures earlier during hospitalization and determining the timing of colonization can allow more targeted choices and reduce morbidity and mortality rates among infected patients.

摘要

背景

在印度等发展中国家,传染病是主要死因。因此,即使因多重耐药病原体导致的感染死亡率相对小幅上升,也会导致全球感染死亡人数大幅增加。

目的

本研究旨在研究社区获得性病原体的微生物学数据以及抗生素耐药性与抗生素敏感性细菌微生物导致的相应结果。

设置与设计

在2022年3月至2023年10月31日的研究期间进行了一项为期两年的单中心前瞻性队列研究。

材料与方法

纳入402例经微生物学诊断为社区获得性感染的患者的所有临床样本。按照标准操作程序收集培养样本并进行处理,记录临床细节。

所用统计分析方法

分类变量以计数和百分比表示。采用Fisher精确检验来检验比例差异。双侧分布值<0.05被认为具有统计学意义。

结果

在革兰氏阳性菌中,[具体菌种1]和[具体菌种2]是主要分离株。在革兰氏阴性菌分离株中,[具体菌种3]和[具体菌种4]是大多数病原体。社区获得性呼吸道感染(CA-RTI)、社区获得性尿路感染(CA-UTI)、社区获得性皮肤和软组织感染(CA-SSTI)以及社区获得性血流感染(CA-BSI)的死亡率分别为13.6%、6.56%、4.5%和31.5%。在CA-RTI、CA-UTI、CA-SSTI和CA-BSI中,住院时间超过三天的比例分别为56.06%、36.2%、40.9%和73.6%。

结论

在住院期间尽早进行培养并确定定植时间,可以做出更有针对性的选择,降低感染患者的发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/11668408/e778530579dc/JFMPC-13-5052-g001.jpg

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