肝硬化患者的多药耐药细菌感染：流行病学研究

StephenW

Multidrug-resistant bacterial infections in cirrhotic patients: an epidemiological study
Ruihong Zhao ORCID Icon, 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, Published online: 05 Sep 2018

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



ABSTRACT

Background: The purpose of this study is to describe the epidemiological features of bacterial infections caused by multidrug-resistant (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 methicillin-resistant Staphylococcus aureus (MRSA). After adjustment for age, sex, and the model for end-stage liver disease (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
Additional information
Funding
This study was supported by grants [Nos. 81500464, 81670567, and 81671949] from National Natural Science Foundation of China.

StephenW

肝硬化患者的多药耐药细菌感染：流行病学研究
赵瑞红ORCID Icon，马建科，李鹏程，洪芳，孙珊珊，吴伟，全部展示
2018年6月13日收到，2018年8月21日接受，接受作者版本在线发布：2018年8月28日，在线发布时间：2019年9月5日

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



抽象

背景：本研究的目的是描述肝硬化患者多药耐药（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，这种增加的死亡率可能主要归因于耐甲氧西林金黄色葡萄球菌（MRSA）。在调整了年龄，性别和终末期肝病（MELD）评分模型后，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，多重耐药细菌，死亡率，预后
附加信息
资金
这项研究得到了资助[编号。 81500464,81670567和81671949]来自国家自然科学基金。