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重症监护病房中由罕见非发酵革兰阴性菌引起的菌血症:单中心经验

Bacteremia Caused by Rare NFGNB in the ICU: A Single-center Experience.

作者信息

Prayag Parikshit S, Rajhans Prasad, Mahale Nilesh, Patwardhan Sampada A, Dhekane Pruthu N, Soman Rajeev N, Sethia Deepak, Dalvi Mousami, Dhupad Surabhi, Tyagi Surabhi, Joshi Rasika S, Deshmukh Abhishek, Wavhal Madhavi, Sharma Priyamvada, Prayag Amrita P

机构信息

Department of Infectious Diseases, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India.

Department of Critical Care Medicine, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India.

出版信息

Indian J Crit Care Med. 2025 Apr;29(4):345-351. doi: 10.5005/jp-journals-10071-24940.

Abstract

INTRODUCTION

Amongst the non-fermenting gram-negative bacteria (NFGNB), (.) and predominate the landscape. However, less common NFGNB such as , , , and species, amongst others, are assuming increasing importance. We describe a single-center experience of caused by rare NFGNBs in an Indian intensive care unit (ICU).

MATERIALS AND METHODS

A retrospective study of adult patients with caused by rare NFGNB in the ICU.

RESULTS

Of the total 205 cases, species (43.4%, = 89) were the commonest, followed by species (20.4%, = 42). The was related to an indwelling catheter in 42.9 % of the patients. The median duration of hospitalization preceding the was 16 days. Except for and , meropenem showed high rates of resistance. Overall, cotrimoxazole, levofloxacin and minocycline were the most effective antibiotics active with some differences noted specific to different organisms. The overall day 28 mortality was 34.1%. On multivariate analysis, the presence of shock ( = 0.008, CI: 1.188-5.052) and receipt of steroids ( = 0.015, CI: 1.032-3.891) were significantly associated with mortality.

CONCLUSIONS

This is one of the largest studies from India, describing the landscape of NFGNB causing in the ICU. Our study shows that these infections are acquired late during the course of hospitalization, have limited therapeutic options, and can be associated with significant mortality. Implementation of stringent infection control practices is needed to reduce this threat.

HOW TO CITE THIS ARTICLE

Prayag PS, Rajhans P, Mahale N, Patwardhan SA, Dhekane PN, Soman RN, . Bacteremia Caused by Rare NFGNB in the ICU: A Single-center Experience. Indian J Crit Care Med 2025;29(4):345-351.

摘要

引言

在非发酵革兰氏阴性菌(NFGNB)中,(.)和 占主导地位。然而,诸如 、 、 、 及 等菌种等不太常见的NFGNB正变得越来越重要。我们描述了在印度一家重症监护病房(ICU)中由罕见NFGNB引起的 单中心经验。

材料与方法

对ICU中由罕见NFGNB引起 的成年患者进行回顾性研究。

结果

在总共205例病例中, 菌种(43.4%, = 89)最为常见,其次是 菌种(20.4%, = 42)。42.9%的患者的 与留置导管有关。 在 之前的中位住院时间为16天。除了 和 外,美罗培南显示出较高的耐药率。总体而言,复方新诺明、左氧氟沙星和米诺环素是对 最有效的抗生素,不同菌种存在一些差异。第28天的总体死亡率为34.1%。多因素分析显示,休克的存在( = 0.008,CI:1.188 - 5.052)和接受类固醇治疗( = 0.015,CI:1.032 - 3.891)与死亡率显著相关。

结论

这是印度规模最大的研究之一,描述了ICU中由NFGNB引起 的情况。我们的研究表明,这些感染是在住院期间后期获得的,治疗选择有限,并且可能与显著的死亡率相关。需要实施严格的感染控制措施以减少这种威胁。

如何引用本文

Prayag PS,Rajhans P,Mahale N,Patwardhan SA,Dhekane PN,Soman RN,. ICU中由罕见NFGNB引起的菌血症:单中心经验。《印度重症监护医学杂志》2025;29(4):345 - 351。

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