重症监护病房耐碳青霉烯肠杆菌科菌血症:危险因素和临床结果的描述性研究

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL
Sivasangari Nachamuthu, Noor Airini Ibrahim, Felicia Su Min Hu, Shahmini Ganesh
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引用次数: 0

摘要

在过去的10年里,碳青霉烯耐药肠杆菌科(CRE)的流行率急剧上升,有许多医院爆发的报道。由CRE引起的菌血症治疗方案有限,且与高死亡率相关。因此,预防CRE传播和CRE血流感染已成为重症监护病房(ICU)患者管理的重要目标。该研究旨在确定重症监护环境中CRE菌血症的发生率和危险因素及其临床结果。材料与方法:进行回顾性描述性研究,收集2017年1月至2018年12月在槟榔岛医院普通ICU收治的患者数据,评估CRE血流感染的发生率、易感因素和临床结局。结果:2585例ICU住院患者中,CRE菌血症37例,发生率为1.43%。一项危险因素分析显示,留置导管的使用与CRE菌血症的相关性最高,其中95%的患者暴露于CRE菌血症。CRE菌血症最常见的微生物是肺炎克雷伯菌(97.3%)和大肠埃希菌(2.7%)。CRE菌血症后30天死亡率为78.4%。结论:ICU患者CRE菌血症死亡率高。大多数患者暴露于多种危险因素。高怀疑指数和快速识别有CRE感染风险的患者对于有效治疗和启动感染控制措施以防止进一步传播非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome
INTRODUCTION: Over the past 10 years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing dramatically with numerous hospital outbreaks reported. Bacteraemia caused by CRE have limited treatment options and have been associated with high mortality rates. As a result, preventing both CRE transmission and CRE bloodstream infections have become important objectives in managing intensive care unit (ICU) patients. The study aims to determine the incidence and risk factors of CRE bacteraemia in intensive care settings, and its’ clinical outcome. MATERIALS AND METHODS: A retrospective, descriptive study was conducted, where data of the patients admitted to general ICU of Hospital Pulau Pinang from January 2017 till December 2018 were collected and assessed for incidence, presence of predisposing factors and clinical outcome for CRE bloodstream infection. RESULTS: Out of 2,585 total ICU admissions, there were 37 cases of CRE bacteraemia with an incidence rate of 1.43%. An analysis of risk factors revealed that the use of indwelling catheter has the highest association with CRE bacteraemia in which 95% of the patients were exposed. The commonest organisms of CRE bacteraemia were Klebsiella pneumoniae (97.3%) and Escherichia coli (2.7%). The 30-day mortality rate after CRE bacteraemia was 78.4%. CONCLUSION: CRE bacteraemia among ICU patients showed a high mortality rate. Most of the patients were exposed to multiple risk factors. A high index of suspicion and rapid identification of patients at risk for CRE infection are important for effective therapy and initiation of infection control measures to prevent further spread.
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来源期刊
International Medical Journal Malaysia
International Medical Journal Malaysia Medicine-Medicine (all)
CiteScore
0.40
自引率
0.00%
发文量
73
期刊介绍: International Medical Journal Malaysia (IMJM) is the official journal of the Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia. It serves primarily as a forum for education and intellectual discourse for health professionals namely in clinical medicine but covers diverse issues relating to medical ethics, professionalism as well as medical developments and research in basic medical sciences. It also serves the unique purpose of highlighting issues and research pertaining to the Muslim world. Contributions to the IMJM reflect its international and multidisciplinary readership and include current thinking across a range of specialties, ethnicities and societies.
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