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首页> 外文期刊>Antimicrobial Resistance and Infection Control >Factors associated with bacteraemia due to multidrug-resistant organisms among bacteraemic patients with multidrug-resistant organism carriage: a case control study
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Factors associated with bacteraemia due to multidrug-resistant organisms among bacteraemic patients with multidrug-resistant organism carriage: a case control study

机译：携带多重耐药菌的细菌患者中由于多重耐药菌引起的菌血症的相关因素：病例对照研究

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Infections caused by multidrug-resistant organisms (MDRO) are emerging worldwide. Physicians are increasingly faced with the question of whether patients need empiric antibiotic treatment covering these pathogens. This question is especially essential among MDRO carriers. We aim to determine the occurrence of MDRO bacteraemia among bacteraemic patients colonized with MDRO, and the associated factors with MDRO bacteraemia among this population. We performed a retrospective monocentric study among MDRO carriers hospitalized with bacteraemia between January 2013 and August 2016 in a French hospital. We compared characteristics of patients with MDRO and non-MDRO bacteraemia. Overall, 368 episodes of bacteraemia were reviewed; 98/368 (26.6%) occurred among MDRO carriers. Main colonizing bacteria were extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (40/98; 40.8%), ESBL-producing Klebsiella pneumoniae (35/98; 35.7%); methicillin-resistant Staphylococcus aureus (26/98; 26.5%) and multidrug-resistant Pseudomonas aeruginosa (PA) (12/98; 12.2%). There was no significant difference considering population with MDRO bacteraemia vs. non-MDRO bacteraemia, except for immunosuppression [OR 2.86; p?=?0.0207], severity of the episode [OR 3.13; p?=?0.0232], carriage of PA [OR 5.24; p?=?0.0395], and hospital-acquired infection [OR 2.49; p?=?0.034]. In the multivariate analysis, factors significantly associated with MDRO bacteraemia among colonized patient were only immunosuppression [OR?=?2.96; p?=?0.0354] and the hospital-acquired origin of bacteraemia [OR?=?2.62; p?=?0.0427]. According to our study, occurrence of bacteraemia due to MDRO among MDRO carriers was high. Factors associated with MDRO bacteraemia were severity of the episode and hospital-acquired origin of the bacteraemia. Thus, during bacteraemia among patients colonized with MDRO, if such characteristics are present, broad-spectrum antimicrobial treatment is recommended.
机译：由多药耐药生物（MDRO）引起的感染正在世界范围内出现。医师越来越面临患者是否需要涵盖这些病原体的经验性抗生素治疗的问题。这个问题在MDRO运营商中尤为重要。我们旨在确定在MDRO定植的细菌性患者中MDRO菌血症的发生情况，以及该人群中MDRO菌血症的相关因素。我们对2013年1月至2016年8月在法国一家医院接受细菌血症住院的MDRO携带者进行了一项回顾性单中心研究。我们比较了MDRO和非MDRO菌血症患者的特征。总体而言，对368例菌血症进行了回顾。 MDRO航母中发生98/368（26.6％）。主要定植细菌是产生广谱β-内酰胺酶（ESBL）的大肠杆菌（40/98; 40.8％），产生ESBL的肺炎克雷伯菌（35/98; 35.7％）;耐甲氧西林的金黄色葡萄球菌（26/98; 26.5％）和耐多药的铜绿假单胞菌（PA）（12/98; 12.2％）。考虑到具有MDRO菌血症的人群与非MDRO菌血症的人群，除免疫抑制外没有显着差异[OR 2.86; p？=？0.0207]，发作的严重程度[OR 3.13; p？=？0.0232]，PA的进位[OR 5.24; p？=？0.0395]和医院获得性感染[OR 2.49; p≥0.034]。在多变量分析中，定植患者中与MDRO菌血症显着相关的因素仅是免疫抑制[OR？=？2.96; p？=？0.0354]和医院获得的菌血症起源[OR？=？2.62; p？=？0.0427]。根据我们的研究，MDRO携带者中MDRO引起的菌血症发生率很高。与MDRO菌血症相关的因素是发作的严重程度和医院获得性菌血症的起源。因此，在MDRO定植的患者发生菌血症期间，如果存在此类特征，则建议使用广谱抗菌治疗。

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