Costa Silvia, Bartilotti Matos Francisca, Gorgulho Ana, Gonçalves Celina, Figueiredo Cristóvão, Coutinho Daniel, Teixeira Tiago, Pargana Margarida, Abreu Gabriela, Malheiro Luís
Medicine, Faculdade de Medicina da Universidade do Porto, Porto, PRT.
Infectious Diseases, Unidade Local de Saúde Gaia Espinho, Vila Nova de Gaia, PRT.
Cureus. 2025 Jun 18;17(6):e86294. doi: 10.7759/cureus.86294. eCollection 2025 Jun.
Introduction ()is an emerging opportunistic Gram-negative bacillus associated with high morbidity and mortality. However, data on its epidemiology in Portugal are limited. This study evaluated the clinical characteristics, risk factors, and outcomes of patients with colonization and infection. Methods This retrospective, single-center cohort study was conducted on adult patients with isolated from clinical specimens between 2020 and 2024. Patients were classified as infected or colonized, with infected cases further divided into survivors and non-survivors. Clinical, microbiological, and treatment data were analyzed using univariate and multivariate methods to identify risk factors for 30-day mortality. Results Among 97 patients, 62.9% had infection and 37.1% were colonized. Infected patients more frequently had cardiovascular disease (31.1% vs. 13.9%) and immunosuppression (24.6% vs. 11.1%). Targeted antimicrobial therapy was administered to 78.7% of infected patients, primarily with co-trimoxazole. Mortality was higher in infected patients (32.8% vs 8.3%, p=0.003). Non-survivors had significantly higher rates of septic shock (66.7% vs. 12.2%, p < 0.01), recent antibiotic exposure (100.0% vs. 73.2%, p = 0.011), and cardiovascular disease (55.0% vs. 19.5%, p = 0.08). Multivariate analysis identified a lack of appropriate therapy (odds ratio (OR) 20.78, 95% CI 1.35-318.6), cardiovascular disease (OR 11.85, 95% CI 1.39-100.49), and septic shock (OR 13.18, 95% CI 1.10-157.37) as independent predictors of 30-day mortality. Conclusion infections, especially in critically ill patients, are associated with high mortality, especially in patients with septic shock, recent antibiotic exposure, and cardiovascular disease. Lack of appropriate antibiotics is also an independent risk factor for mortality. Early diagnosis, prompt targeted therapy, and optimal management of comorbidities are crucial to improving outcomes.
引言 （）是一种新兴的机会性革兰氏阴性杆菌，与高发病率和高死亡率相关。然而，关于其在葡萄牙的流行病学数据有限。本研究评估了感染和定植患者的临床特征、危险因素及转归。方法 本回顾性单中心队列研究针对2020年至2024年间从临床标本中分离出的成年患者进行。患者被分为感染组或定植组，感染病例进一步分为存活者和非存活者。使用单变量和多变量方法分析临床、微生物学和治疗数据，以确定30天死亡率的危险因素。结果 在97例患者中，62.9%发生了感染，37.1%为定植。感染患者更常患有心血管疾病（31.1%对13.9%）和免疫抑制（24.6%对11.1%）。78.7%的感染患者接受了针对性抗菌治疗，主要使用复方新诺明。感染患者的死亡率更高（32.8%对8.3%，p = 0.003）。非存活者的感染性休克发生率显著更高（66.7%对12.2%，p < 0.01）、近期有抗生素暴露史（100.0%对73.2%，p = 0.011）以及心血管疾病发生率（55.0%对19.5%，p = 0.08）。多变量分析确定缺乏适当治疗（比值比（OR）20.78，95%置信区间1.35 - 318.6）、心血管疾病（OR 11.85，95%置信区间1.39 - 100.49）和感染性休克（OR 13.18，95%置信区间1.10 - 157.37）是30天死亡率的独立预测因素。结论 感染，尤其是在重症患者中，与高死亡率相关，特别是在患有感染性休克、近期有抗生素暴露史和心血管疾病的患者中。缺乏适当的抗生素也是死亡率的独立危险因素。早期诊断、及时的针对性治疗以及对合并症的优化管理对于改善转归至关重要。
