肠球菌相关的卫生保健相关脑室炎和脑膜炎:来自临床实践的多中心回顾性病例系列

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Yuyang Qiu, Yi Ye, Qiujun Yang, Jixun Zhao, Xiaobo Gong, Yimin Ma, Guangzhi Shi, Guiyun Li, Guofeng Wu
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引用次数: 0

摘要

卫生保健相关性脑室炎和脑膜炎(HCAVM)是一种严重感染,与高发病率、死亡率和不良功能预后相关,相关微生物可以是皮肤菌群或医院病原体,最常见的是革兰氏阴性菌。肠球菌相关的HCAVM很少有系统的讨论,相关的耐药和结局研究很少。在这个多中心回顾性病例系列中,我们分析了来自三家三级医院的肠球菌相关HCAVM患者。我们的研究评估了该患者队列中的细菌耐药模式、抗菌药物治疗策略和临床结果。共检出引起HCAVM的肠球菌94株,其中粪肠球菌58株,屎肠球菌34株。万古霉素耐药率为7.4%(7/94),仅发生在粪肠杆菌中。利奈唑胺耐药率1.1%(1/94)。10种抗菌药物对粪肠杆菌的耐药率高于对粪肠球菌的耐药率。88例患者采用万古霉素作为经验治疗,12例患者改用利奈唑胺,其中包括耐万古霉素的粪肠杆菌。治疗无效4例(4.3%),预后不良8例(8.5%),疗程为15.3±10.9 d。综上所述,我们的研究结果揭示了粪肠球菌和屎肠球菌对万古霉素和利奈唑胺的不同耐药率,揭示了肠球菌相关HCAVM的临床流行病学特征,为抗菌药物的选择提供了重要参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Enterococci-related healthcare-associated ventriculitis and meningitis: a multicenter retrospective case series from clinical practice.

Healthcare-associated ventriculitis and meningitis (HCAVM) is a severe infection and is associated with high morbidity, mortality, and poor functional prognosis, and the associated microorganisms can be skin flora or nosocomial pathogens, most commonly Gram-negative bacteria. Enterococci-related HCAVM have rarely been discussed systemically, the related drug resistance and outcomes have been poorly researched. In this multicenter retrospective case series, we analyzed patients with Enterococci-related HCAVM from three tertiary hospitals. Our study assessed bacterial resistance patterns, antimicrobial treatment strategies, and clinical outcomes in this patient cohort. A total of 94 strains of Enterococci causing HCAVM were identified, including 58 strains of Enterococcus faecalis and 34 strains of Enterococcus faecium. Vancomycin resistance rate was 7.4%(7/94), which only occurred in E. faecium. The linezolid resistance rate was 1.1%(1/94). Ten tested antimicrobial agents showed higher resistance rates against E. faecium than against E. faecalis. Vancomycin was used in 88 patients as empirical treatment, which was changed to linezolid in 12 patients, including those with vancomycin-resistant E. faecium. Four (4.3%) patients experienced ineffective treatments, eight (8.5%) had poor outcomes, and the treatment course was 15.3 ± 10.9 days. In conclusion, our findings reveal the different resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin and linezolid, reveal the clinical epidemiological characteristics of Enterococci-related HCAVM, and provide an important reference for the selection of antimicrobial agents.

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来源期刊
BMC Neurology
BMC Neurology 医学-临床神经学
CiteScore
4.20
自引率
0.00%
发文量
428
审稿时长
3-8 weeks
期刊介绍: BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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