一项前瞻性研究:一家三级癌症医院癌症患者抗菌药敏感性模式、风险因素及其对死亡率的影响调查。

IF 4.6 2区 医学 Q1 MICROBIOLOGY
Akshay Shelke, Pallavi Priya, Shiwani Mishra, Richa Chauhan, Krishna Murti, V Ravichandiran, Sameer Dhingra
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引用次数: 0

摘要

背景:由于癌症本身及其治疗造成的免疫抑制,癌症患者很容易受到感染。抗菌细菌的出现使感染治疗更加复杂,并增加了死亡率和住院时间。本研究旨在调查这些患者的微生物谱、抗菌药耐药性模式、风险因素及其对临床结果的影响:在印度比哈尔邦巴特那市的一家三级癌症医院开展了一项前瞻性研究,研究对象包括微生物培养呈阳性的 18 岁及以上癌症患者:本研究分析了 440 名患者,其中 53%(234 人)为女性,平均年龄为 49.27(± 14.73)岁。共鉴定出 541 株分离菌,其中 48.01%(242 株)为多重耐药菌(MDR),29.76%(150 株)为广泛耐药菌(XDR),19.84%(112 株)为敏感菌。该研究显示,接受过手术、化疗、住院治疗、有抗生素接触史和严重中性粒细胞减少症的患者更容易发生 MDR 和 XDR 感染。敏感、MDR 和 XDR 感染患者的平均住院时间分别为 16.90 天(± 10.23)、18.30 天(± 11.14)和 22.83 天(± 13.22)。研究还显示,30 天的总死亡率为 31.81%(140),而 MDR 和 XDR 组的 30 天死亡率分别为 38.92% 和 50.29%(P):本研究强调了对癌症患者进行个性化干预的必要性,如识别有感染风险的患者、合理使用抗生素、采取感染控制措施以及实施抗菌药物管理计划,以降低抗菌药物耐药感染率,减少相关死亡率和住院时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Investigation of antimicrobial susceptibility patterns, risk factors and their impact on mortality in cancer patients at a tertiary care cancer hospital- A prospective study.

Background: Cancer patients are vulnerable to infections due to immunosuppression caused by cancer itself and its treatment. The emergence of antimicrobial-resistant bacteria further complicates the treatment of infections and increases the mortality and hospital stays. This study aimed to investigate the microbial spectrum, antimicrobial resistance patterns, risk factors, and their impact on clinical outcomes in these patients.

Methods: A prospective study was conducted at a tertiary care cancer hospital in Patna, Bihar, India, which included cancer patients aged 18 years and older with positive microbial cultures.

Results: This study analysed 440 patients, 53% (234) of whom were females, with an average age of 49.27 (± 14.73) years. A total of 541 isolates were identified, among which 48.01% (242) were multidrug resistant (MDR), 29.76% (150) were extensively drug resistant (XDR), and 19.84% (112) were sensitive. This study revealed that patients who underwent surgery, chemotherapy, were hospitalized, had a history of antibiotic exposure, and had severe neutropenia were more susceptible to MDR and XDR infections. The average hospital stays were 16.90 (± 10.23), 18.30 (± 11.14), and 22.83 (± 13.22) days for patients with sensitive, MDR, and XDR infections, respectively. The study also revealed overall 30-day mortality rate of 31.81% (140), whereas the MDR and XDR group exhibited 38.92% and 50.29% rates of 30-day mortality respectively (P < 0.001). Possible risk factors identified that could lead to mortality, were cancer recurrence, sepsis, chemotherapy, indwelling invasive devices such as foley catheter, Central venous catheter and ryles tube, MASCC score (< 21) and pneumonia.

Conclusions: This study emphasizes the necessity for personalized interventions among cancer patients, such as identifying patients at risk of infection, judicious antibiotic use, infection control measures, and the implementation of antimicrobial stewardship programs to reduce the rate of antimicrobial-resistant infection and associated mortality and hospital length of stay.

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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
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