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血流感染中多重耐药革兰氏阴性病原体的临床与微生物学视角

Clinical and microbiological perspectives on multidrug-resistant gram-negative pathogens in bloodstream infections.

作者信息

Sannathimmappa Mohan Bilikallahalli, Divecha Chhaya Akshay, Al Balushi Reem Sulaiman Mohammed, Al-Saidi Al-Shifa Khalifa, Aravindakshan Rajeev, Nambiar Vinod, Al-Risi Elham Said, Al-Maqbali Salima

机构信息

Department of Microbiology, College of Medicine and Health Sciences, National University of Science and Technology, Sohar, Oman.

Department of Pediatrics, College of Medicine and Health Sciences, National University of Science and Technology, Sohar, Oman.

出版信息

Int J Crit Illn Inj Sci. 2025 Apr-Jun;15(2):74-81. doi: 10.4103/ijciis.ijciis_75_24. Epub 2025 Jun 23.

Abstract

INTRODUCTION

Bloodstream infections (BSIs) caused by multidrug-resistant (MDR) Gram-negative bacilli pose a significant challenge in healthcare settings around the world. The main objective of this research was to determine the incidence, etiology, risk factors, and sources of BSIs among patients treated at Sohar Hospital in Oman.

METHODS

The study employed a retrospective methodology at Sohar Hospital, Oman, analyzing patients with BSIs from January 2018 to December 2019 utilizing electronic health data. Demographic data, bacterial etiology, antibiotic susceptibility, and patient outcomes were obtained from electronic health records. The statistical tools employed comprised -tests, Mann-Whitney tests, Chi-square tests, and Fisher's exact tests for variable comparison, alongside univariate odds ratios computed for mortality correlations utilizing the R package GTSUMMARY. Bacterial identification and testing was performed in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines utilizing both traditional methods and automated technologies.

RESULTS

The majority of BSIs occur in elderly individuals with comorbidities. Surgical intervention was identified as a predominant risk factor for adverse consequences. MDR infections were linked with higher mortality rates. and were prevalent, with . exhibiting resistance to several antibiotics.

CONCLUSIONS

The study highlights the urgent requirement for effective monitoring, management and infectious control measures to reduce the impact of BSIs and MDR pathogens on patient outcomes. It contributes valuable insights into the local epidemiology of BSIs in Oman. It emphasizes the significance of tailored interventions and precise medications to address the growing threat of antimicrobial resistance in healthcare settings.

摘要

引言

由多重耐药(MDR)革兰氏阴性杆菌引起的血流感染(BSIs)在全球医疗环境中构成了重大挑战。本研究的主要目的是确定阿曼苏哈尔医院接受治疗的患者中血流感染的发病率、病因、危险因素和感染源。

方法

该研究在阿曼苏哈尔医院采用回顾性方法,利用电子健康数据分析2018年1月至2019年12月期间患有血流感染的患者。从电子健康记录中获取人口统计学数据、细菌病因、抗生素敏感性和患者预后信息。所采用的统计工具包括用于变量比较的t检验、曼-惠特尼检验、卡方检验和费舍尔精确检验,以及利用R包GTSUMMARY计算死亡率相关性的单变量比值比。细菌鉴定和检测按照临床和实验室标准协会(CLSI)指南,采用传统方法和自动化技术进行。

结果

大多数血流感染发生在患有合并症的老年人中。手术干预被确定为不良后果的主要危险因素。多重耐药感染与较高的死亡率相关。[此处原文可能缺失部分内容]很普遍,[此处原文可能缺失部分内容]。[此处原文可能缺失部分内容]对几种抗生素表现出耐药性。

结论

该研究强调了迫切需要有效的监测、管理和感染控制措施,以减少血流感染和多重耐药病原体对患者预后的影响。它为阿曼血流感染的当地流行病学提供了有价值的见解。它强调了针对性干预和精确用药对于应对医疗环境中日益增长的抗菌药物耐药性威胁的重要性。

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