Emerging Prevalence and Clinical Features of Elizabethkingia meningoseptica Infection in Southwest China: A 9-Year Retrospective Study and Systematic Review.
Emerging Prevalence and Clinical Features of Elizabethkingia meningoseptica Infection in Southwest China: A 9-Year Retrospective Study and Systematic Review.
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DOI：
10.2147/idr.s397051
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发表时间：
2023
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
作者：
脑膜炎败血症嗜盐菌感染已逐渐成为世界范围内危及生命的医院感染，伴随着发病率的增加、多药耐药和不良结局。然而，流行病学和临床特征的E。脑膜炎败血症感染在中国大陆仍然有限。E.回顾性分析了2011 - 2019年中国西南地区脑膜炎败血症感染情况。从病历中提取临床特征、感染模式和结局并进行分析。根据PRISMA指南，从概念到2021年8月23日进行了全面的系统评价。最终纳入92例患者，患病率从2011年的0例迅速上升至2019年的每1000名住院患者0. 19例。E.脑膜炎败血症分离株是多重耐药的，包括对碳青霉烯100%耐药。75%的E.脑膜炎败血症感染与其他病原体共存。本组死亡率为36.96%，主要危险因素为机械通气（OR=9.51，P=0.004）、男性（OR=0.27，P=0.031）及合并病原体多。倾向评分匹配后，中心静脉导管、暴露于碳青霉烯类和抗真菌药物以及潜在肿瘤与E。脑膜败血症感染还总结了16篇文章，报告的死亡率范围为11.0%-66.6%。血液和呼吸道是常见的感染源。敏感性最高的抗生素为氨苄西林/他唑巴坦、甲氧苄啶/磺胺甲恶唑、氟喹诺酮和米诺环素。不适当的抗生素治疗是最常见的死亡风险因素。医院感染E.脑膜炎败血症已成为中国西南地区的一个新兴问题，死亡率很高。不适当的抗生素治疗和中心静脉导管是感染和死亡的危险因素，应得到足够的重视。
Elizabethkingia meningoseptica infections have gradually emerged as life-threatening nosocomial infections worldwide, accompanied by increasing incidence, multidrug resistance and poor outcomes. However, the epidemiology and clinical features of E. meningoseptica infection are still limited in mainland China. Patients with E. meningoseptica infections from 2011 to 2019 in southwestern China were retrospectively analyzed. The clinical features, infection patterns and outcomes were extracted from medical records and analyzed. A comprehensive systematic review was performed in accordance with PRISMA guidelines from conception to August 23, 2021. Ninety-two patients were ultimately included, with the prevalence rapidly rising from 0 in 2011 to 0.19 per 1000 inpatients in 2019. A total of 93.48% of E. meningoseptica isolates were multidrug resistant, including 100% resistance to carbapenem. Furthermore, 75% of E. meningoseptica infections were concomitant with other pathogens. The mortality of our cohort was 36.96%, with risk factors for mechanical ventilation (OR=9.51, P=0.004), male sex (OR=0.27, P=0.031) and more concomitant pathogens. After propensity score matching, central venous catheters, exposure to carbapenem and antifungal drugs, and underlying tumors were associated with E. meningoseptica infection. Sixteen articles were also summarized, with reported mortality rates ranging from 11.0% to 66.6%. Blood and respiratory tract were the common sources. Piperacillin/tazobactam, trimethoprim/sulfamethoxazole, fluoroquinolone and minocycline were the most sensitive antibiotics. Inappropriate antibiotic treatment was the most commonly reported risk factor for mortality. Nosocomial infection with E. meningoseptica has become an emerging problem with high mortality in southwestern China. Inappropriate antibiotic treatment and central venous catheters are risk factors for infection and death and should receive adequate attention.
影响因子：
1.1
作者：
Patro P;Das P;Padhi P
通讯作者：
Padhi P