Clinical and microbiological features of positive blood culture episodes caused by non-fermenting gram-negative bacilli other than Pseudomonas and Acinetobacter species (2020-2023).

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-02-01 Epub Date: 2024-07-11 DOI:10.1007/s15010-024-02342-6

Roberto Casale, Matteo Boattini, Sara Comini, Paulo Bastos, Silvia Corcione, Francesco Giuseppe De Rosa, Gabriele Bianco, Cristina Costa

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引用次数: 0

Abstract

Introduction: Non-fermenting Gram-negative bacilli (NFGNB) other than Pseudomonas aeruginosa and Acinetobacter baumannii complex are pathogens of interest due to their ability to cause health-care associated infections and display complex drug resistance phenotypes. However, their clinical and microbiological landscape is still poorly characterized.

Methods: Observational retrospective study including all hospitalized patients presenting with a positive positive blood culture (BC) episode caused by less common NFGNB over a four-year period (January 2020-December 2023). Clinical-microbiological features and factors associated with mortality were investigated.

Results: Sixty-six less common NFGNB isolates other than Pseudomonas and Acinetobacter species causing 63 positive BC episodes were recovered from 60 patients. Positive BC episodes were predominantly sustained by Stenotrophomonas maltophilia (49.2%) followed by Achromobacter species (15.9%) that exhibited the most complex resistance phenotype. Positive BC episodes had bloodstream infection criteria in 95.2% of cases (60 out 63), being intravascular device (30.2%) and respiratory tract (19.1%) the main sources of infection. Fourteen-day, 30-day, and in-hospital mortality rates were 6.4%, 9.5%, and 15.9%, respectively. The longer time from admission to the positive BC episode, older age, diabetes, admission due to sepsis, and higher Charlson Comorbidity Index were identified as the main predictors of in-hospital mortality.

Conclusions: Positive BC episodes sustained by NFGNB other than Pseudomonas and Acinetobacter species were predominantly sustained by Stenotrophomonas maltophilia and Achromobacter species, having bloodstream infection criteria in the vast majority of cases. Factors that have emerged to be associated with mortality highlighted how these species may have more room in prolonged hospitalisation and at the end of life for patients with chronic organ diseases.

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除假单胞菌和不动杆菌外，由非发酵革兰氏阴性杆菌引起的血液培养阳性病例的临床和微生物学特征（2020-2023 年）。

导言：除铜绿假单胞菌和鲍曼不动杆菌复合菌以外的非发酵革兰氏阴性杆菌（NFGNB）是一种令人感兴趣的病原体，因为它们能够引起与医疗保健相关的感染，并表现出复杂的耐药性表型。然而，它们的临床和微生物学特征仍不十分明确：观察性回顾研究包括所有在四年内（2020 年 1 月至 2023 年 12 月）由不太常见的 NFGNB 引起的血培养（BC）阳性的住院患者。调查了临床微生物学特征以及与死亡率相关的因素：结果：从 60 名患者体内分离出 66 株较少见的 NFGNB（除假单胞菌和不动杆菌外），导致 63 例 BC 阳性病例。BC 阳性病例主要由嗜麦芽血单胞菌（49.2%）引起，其次是耐药表型最复杂的阿奇霉素菌（15.9%）。BC 阳性病例中有 95.2% 的病例（63 例中有 60 例）符合血流感染标准，血管内装置（30.2%）和呼吸道（19.1%）是主要感染源。14天、30天和院内死亡率分别为6.4%、9.5%和15.9%。从入院到BC阳性发作的时间较长、年龄较大、患有糖尿病、因败血症入院以及夏尔森综合指数较高被认为是院内死亡率的主要预测因素：除假单胞菌和醋氨曲霉菌外，NFGNB引起的BC阳性病例主要由嗜麦芽气单胞菌和阿奇霉素引起，绝大多数病例符合血流感染标准。与死亡率相关的因素突出表明，这些菌种在慢性器官疾病患者长期住院和生命末期可能有更大的生存空间。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.