Clinical outcomes of bacteremic pneumococcal pneumonia in the era of antibiotic resistance
Clinical outcomes of bacteremic pneumococcal pneumonia in the era of antibiotic resistance
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DOI：
10.1086/322623
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发表时间：
2001-09-15
影响因子：
11.8
通讯作者：
Schuchat, A
中科院分区：
文献类型：
--
作者：
Moroney, JF;Fiore, AE;Schuchat, A
关于抗菌素耐药性对肺炎球菌肺炎病例临床结局的影响，现有数据有限。研究对象为146例因肺炎链球菌（头孢噻肟的最低抑菌浓度大于或等于25 μ g/mL）所致的侵袭性肺炎住院患者，这些患者是通过1994年11月至1996年4月期间基于人群的主动监测确定的。与感染敏感性更高的S。肺炎，死亡或入住重症监护室的受试者比例没有显著差异。多变量分析显示，抗菌药物耐药性对死亡率或重症监护室护理需求没有显著影响。在这组住院患者中，检测抗生素耐药性对这些重要结局指标影响的能力可能受到积极的多药经验性治疗的影响。耐药性以外的因素，如就诊时疾病的严重程度和预先指示状态（“不复苏”命令），似乎对肺炎球菌性肺炎的结局有更大的影响。
Limited data are available about the impact of antimicrobial resistance on clinical outcomes in cases of pneumococcal pneumonia. This was studied in 146 persons hospitalized with invasive pneumonia due to Streptococcus pneumoniae (minimum inhibitory concentration of cefotaxime, greater than or equal to 25 mug/mL) who were identified through population-based active surveillance for the period of November 1994 through April 1996. Compared with matched control subjects who had infection with more-susceptible S. pneumoniae, the proportion of subjects who died or who were admitted to an intensive care unit did not differ significantly. Multivariable analysis showed no significant contribution of antimicrobial resistance to mortality or the requirement for care in an intensive care unit. The ability to detect an effect of antimicrobial resistance on these important outcome measures may have been influenced by aggressive multidrug empirical therapy in this group of hospitalized patients. Factors other than resistance, such as severity of illness at presentation and advance directive status ("do not resuscitate" orders), appear to have a stronger influence on pneumococcal pneumonia outcomes.