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菌血症患者中[具体内容缺失]的持续存在:发病率、临床和微生物学特征及结局

Persistence of in Patients with Bacteremia: Incidence, Clinical and Microbiologic Characters, and Outcomes.

作者信息

Kim Sarah, Ji Sehyeon, Cho David, Lee Ahrang, Jeong Hae Seong, Kim Minji, Kim Seong Eun, Park Kyung-Hwa, Jung Sook In, Kim Uh Jin, Shin Sung Un, Kang Seung Ji

机构信息

Department of Infectious Disease, Chonnam National University Hospital, Gwangju 61469, Republic of Korea.

Department of Infectious Disease, Chonnam National University Hwasun Hospital, Hwasun 58128, Republic of Korea.

出版信息

Microorganisms. 2024 Dec 2;12(12):2477. doi: 10.3390/microorganisms12122477.

Abstract

The risk factors and outcomes associated with persistent bacteremia are not well-defined. This retrospective cohort study analyzed 214 cases of bacteremia diagnosed between 2005 and 2022 at two university hospitals, focusing on the clinical and microbiologic characteristics and outcomes of persistent bacteremia. Persistent bacteremia, defined as the detection of for ≥5 days after the initial blood culture, occurred in 25.7% of cases and was significantly associated with mechanical ventilation, polymicrobial infections, and increased 30-day mortality. The early administration of appropriate antibiotics reduced the likelihood of persistence. Isolates from persistent cases demonstrated increased biofilm formation. Molecular typing revealed no specific genotype linked to bacteremia persistence. Resistance to trimethoprim-sulfamethoxazole significantly increased over the study period. Our study offers new insights into the under-explored issue of persistent bacteremia, a condition that constitutes a notable proportion of bloodstream infections and carries high mortality.

摘要

与持续性菌血症相关的危险因素和结局尚未明确界定。这项回顾性队列研究分析了2005年至2022年间在两家大学医院诊断出的214例菌血症病例,重点关注持续性菌血症的临床和微生物学特征及结局。持续性菌血症定义为在初次血培养后≥5天检测到菌血症,发生在25.7%的病例中,并且与机械通气、多微生物感染及30天死亡率增加显著相关。早期给予适当的抗生素可降低持续性菌血症的发生可能性。持续性菌血症病例的分离株显示出生物膜形成增加。分子分型未发现与菌血症持续性相关的特定基因型。在研究期间,对甲氧苄啶-磺胺甲恶唑的耐药性显著增加。我们的研究为持续性菌血症这一研究较少的问题提供了新的见解,持续性菌血症在血流感染中占相当比例且死亡率很高。

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本文引用的文献

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Bacterial persisters: molecular mechanisms and therapeutic development.细菌持久态:分子机制与治疗开发。
Signal Transduct Target Ther. 2024 Jul 17;9(1):174. doi: 10.1038/s41392-024-01866-5.
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Risk factors for mortality in bacteremia - a meta-analysis.菌血症患者死亡的风险因素:一项荟萃分析。
Infect Dis (Lond). 2024 May;56(5):335-347. doi: 10.1080/23744235.2024.2324365. Epub 2024 Mar 4.
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Successful Treatment of Persistent Bacteremia With Cefiderocol in an Infant.用头孢地尔成功治疗婴儿持续性菌血症
Open Forum Infect Dis. 2023 Mar 29;10(4):ofad174. doi: 10.1093/ofid/ofad174. eCollection 2023 Apr.

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