猫和狗传播的脓毒症ICU患者的特征和结局：PETSEPSIS多中心回顾性观察队列研究
Characteristics and outcomes of ICU patients with sepsis transmitted by cats and dogs: the PETSEPSIS multicentre retrospective observational cohort study.
作者信息
Quintin Juliette, Le Thuaut Aurélie, Plouvier Fabienne, Zerbib Yoann, Sirodot Michel, Sedillot Nicholas, de Longeaux Kahaia, Le Meur Anthony, Souweine Bertrand, Quenot Jean-Pierre, Lacherade Jean-Claude, Noublanche Julie, Landais Mickael, Thevenin Didier, Nseir Saad, Lafon Thomas, Vanderlinden Thierry, Smonig Roland, Argaud Laurent, Chauvelot Louis, Dubois Marlène, Larcher Romaric, Berteau Florian, Dellamonica Jean, Barbar Saber, Serie Mathieu, Kamel Toufik, Jacobs Frederic, De Prost Nicolas, Devaquet Jérôme, Heming Nicholas, Pineton De Chambrun Marc, Michel Philippe, Djibre Michel, Ferre Alexis, Picard Walter, Pinceaux Kieran, Tamion Fabienne, Legay François, Jonas Maud, Curtiaud Anaïs, Ehrmann Stephan, Huntzinger Julien, Cracco Christophe, Schortgen Frederique, Letocart Philippe, Reignier Jean
机构信息
Service de Médecine Intensive Réanimation, Centre Hospitalier Universitaire de Nantes, Nantes, France.
Direction de la recherche, Plateforme de Méthodologie et Biostatistique, Centre Hospitalier Universitaire de Nantes, Nantes, France.
出版信息
Crit Care. 2025 Jul 22;29(1):315. doi: 10.1186/s13054-025-05558-6.
BACKGROUND
Millions of households have cats or dogs as pets, and infections due to bites or scratches are increasing, with the most common pathogens being spp., spp., spp, and . The objective of this study was to describe patients admitted to the intensive care unit (ICU) for infection transmitted by cats or dogs, as well as their outcomes.
METHODS
The retrospective multicentre observational cohort study PETSEPSIS included consecutive adults admitted to 46 ICUs in France between 2009 and 2019 for sepsis due to cat or dog bites and/or caused by any of the four above-listed bacteria. We described their features and outcomes and performed univariate and multivariate analyses to identify factors associated with death.
RESULTS
We included 174 patients with a median age of 64 [50–74] years; 58.1% were male. The median SAPS II score was 42 [28–58]. Mechanical ventilation was required in 51.2% of patients, for a median duration of 7 [4–13] days. Vasopressor support was used in 53.5%, renal replacement therapy in 19%, and limb amputation in 3.6% of the patients. The median ICU length of stay was 7 [4–16] days. Hospital mortality was 24.1%. The clinical presentation and severity of sepsis were similar across bacteria, although patients with spp. were older and had more comorbidities. Contact with cats were more often reported for spp. and spp. infections and contact with dogs for spp. infections. Risk factors for hospital mortality present on ICU admission were older age, smoking, preexisting liver disease, high serum creatinine, and anaemia. Neither the type of micro-organism nor the initial antimicrobial treatment was associated with mortality.
CONCLUSIONS
This large multicentre study shows that infections transmitted by cats and dogs are infrequent reasons for ICU admission but are associated with substantial morbidity and mortality. Mortality was associated with older age and comorbidities but not with the type of microorganism or initial antibiotic treatment.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s13054-025-05558-6.
背景
数以百万计的家庭养猫或狗作为宠物，因被咬伤或抓伤而导致的感染正在增加，最常见的病原体是 属、 属、 属和 。本研究的目的是描述因猫或狗传播感染而入住重症监护病房（ICU）的患者及其预后。
方法
回顾性多中心观察性队列研究PETSEPSIS纳入了2009年至2019年间在法国46个ICU因猫或狗咬伤和/或由上述四种细菌中的任何一种引起的败血症而连续入院的成年人。我们描述了他们的特征和预后，并进行了单变量和多变量分析以确定与死亡相关的因素。
结果
我们纳入了174例患者，中位年龄为64岁[50 - 74岁]；58.1%为男性。SAPS II评分中位数为42[28 - 58]。51.2%的患者需要机械通气，中位持续时间为7天[4 - 13天]。53.5%的患者使用血管活性药物支持，19%的患者接受肾脏替代治疗，3.6%的患者进行肢体截肢。ICU住院时间中位数为7天[4 - 16天]。医院死亡率为24.1%。尽管感染 属的患者年龄较大且合并症较多，但不同细菌引起的败血症的临床表现和严重程度相似。感染 属和 属的患者更常报告与猫接触，而感染 属的患者更常报告与狗接触。入住ICU时医院死亡的危险因素包括年龄较大、吸烟、既往肝病、高血清肌酐和贫血。微生物类型和初始抗菌治疗均与死亡率无关。
结论
这项大型多中心研究表明，猫和狗传播的感染是入住ICU的罕见原因，但与严重的发病率和死亡率相关。死亡率与年龄较大和合并症有关，但与微生物类型或初始抗生素治疗无关。
补充信息
在线版本包含可在10.1186/s13054-025-05558-6获取的补充材料。
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