肝硬化患者的多药耐药细菌感染：流行病学研究

StephenW

Original Research
Multidrug-resistant bacterial infections in cirrhotic patients: an epidemiological study
Ruihong Zhao, Jianke Ma, Pengcheng Li, Hong Fang, Shanshan Sun, Wei Wu, show all
Received 13 Jun 2018, Accepted 21 Aug 2018, Accepted author version posted online: 28 Aug 2018

    Download citation https://doi.org/10.1080/17474124.2018.1515627

Accepted author version
Abstract

Background: The purpose of this study is to describe the epidemiological features of bacterial infections caused by MDR bacteria in cirrhotic patients and their impact on mortality.

Methods: A retrospective study of cirrhotic patients with culture-confirmed bacterial infections was performed between 2011 and 2017.

Results: A total of 635 episodes in 563 patients with cirrhosis were included. Bacterial infections caused by MDR isolates accounted for 44.1% (280/635) of the episodes, nearly half of which were hospital acquired (48.4%). The most common MDR isolation site was the respiratory tract (36.4%, 102 episodes), followed by the abdominal cavity (35.4%, 99 episodes). Of the MDR isolates, carbapenem-resistant Enterobacteriaceae (CRE) (91 episodes) were the most common. Patients infected with MDR bacteria had significantly higher mortality than those not infected (25.1% vs 17.4%, p=0.025). However, this increased mortality could be largely attributed to MRSA. After adjustment for age, sex and the MELD score, only MRSA infection was an independent risk factor for 28-day mortality in the multivariable Cox proportional hazard regression model analysis (HR, 2.964, 95% CI (1.175-7.478), p=0.021).

Conclusions: MDR bacterial infections, especially CRE, have become frequent in patients with cirrhosis in recent years, with MRSA infections significantly increasing short-term mortality.
Keywords: Bacterial infections, liver cirrhosis, multidrug-resistant bacteria, mortality, prognosis

StephenW

原创研究
肝硬化患者的多药耐药细菌感染：流行病学研究
赵瑞红，马建科，李鹏程，洪芳，孙珊珊，吴伟，全部展示
收稿日期2018年6月13日，接受2018年8月21日，接受作者发布于2018年8月28日

    下载引文https://doi.org/10.1080/17474124.2018.1515627

接受的作者版本
抽象

背景：本研究的目的是描述肝硬化患者MDR细菌引起的细菌感染的流行病学特征及其对死亡率的影响。

方法：对2011年至2017年间培养证实的细菌感染的肝硬化患者进行回顾性研究。

结果：共纳入563例肝硬化患者的635次发作。由MDR分离株引起的细菌感染占发作的44.1％（280/635），其中近一半是医院获得的（48.4％）。最常见的MDR分离部位是呼吸道（36.4％，102集），其次是腹腔（35.4％，99集）。在MDR分离株中，碳青霉烯抗性肠杆菌科（CRE）（91集）是最常见的。感染MDR细菌的患者死亡率显着高于未感染的患者（25.1％vs 17.4％，p = 0.025）。然而，死亡率上升可能主要归因于MRSA。在调整年龄，性别和MELD评分后，在多变量Cox比例风险回归模型分析中，仅MRSA感染是28天死亡率的独立危险因素（HR，2.964,95％CI（1.175-7.478），p = 0.021 ）。

结论：MDR细菌感染，特别是CRE，近年来在肝硬化患者中频繁发生，MRSA感染显着增加短期死亡率。
关键词：细菌感染，肝硬化，多药耐药细菌，死亡率，预后