Epidemiology and Outcomes of Complicated Skin and Soft Tissue Infections among Inpatients in Southern China from 2008 to 2013.
Epidemiology and Outcomes of Complicated Skin and Soft Tissue Infections among Inpatients in Southern China from 2008 to 2013.
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DOI：
10.1371/journal.pone.0149960
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Wen Z
中科院分区：
文献类型：
--
作者：
Li X;Chen Y;Gao W;Ouyang W;Wei J;Wen Z
复杂性皮肤软组织感染(CSSTI)是医院最常见的感染之一，给患者和社会带来了沉重的经济负担。在这里，我们报告了在中国住院人群中进行的一项回顾研究的基础上对cSSTI进行分析的结果。我们的研究集中在患者群体、抗生素治疗、临床结果和经济负担的分析上。研究人群包括2008年至2013年期间住院的527名选定患者。在有微生物诊断的住院患者中，61.41%(n=113)的患者感染革兰氏阳性菌，46.20%(n=85)的患者感染革兰氏阴性杆菌。革兰氏阳性菌最常见的是金黄色葡萄球菌(40.76%，n=75)，最常见的革兰氏阴性菌是大肠埃希菌(14.13%，n=26)。约20%的金黄色葡萄球菌对甲氧西林耐药。分离的金黄色葡萄球菌和大肠埃希菌对青霉素的耐药率在90%左右，对万古霉素、利奈唑胺和亚胺培南的耐药率较低，为20%。很大比例的患者使用头孢菌素和氟喹诺酮类药物治疗，而万古霉素和亚胺培南也用于治疗耐药病原体。超过一半的住院患者(58.43%，n=336)经历了治疗修改。进行抗生素修改的患者的成本相对高于没有进行抗生素修改的患者。综上所述，本研究分析了广东省4所医院慢性性病的发病特点、微生物学诊断、治疗模式和临床转归，为中国医院目前的临床管理提供了参考。
Complicated skin and soft tissue infections (cSSTI) are some of the most commonly treated infections in hospitals, and place heavy economic burdens on patients and society. Here we report the findings from an analysis of cSSTI based on a retrospective study which was conducted within the Chinese inpatient population. We focused our research on the analysis of the patient population, antibiotic treatment, clinical outcome and economic burden. The study population comprised 527 selected patients hospitalized between 2008 and 2013. Among the hospitalizations with microbiological diagnoses, 61.41% (n = 113) were diagnosed as infected with Gram-positive bacteria, while 46.20% (n = 85) were infected with Gram-negative bacteria. The most commonly found Gram-positive bacteria was Staphylococcus aureus (40.76%, n = 75), and the most common Gram-negative bacteria was Escherichia coli (14.13%, n = 26). About 20% of the Staphylococcus aureus were methicillin-resistant. The resistance rate of isolated Staphylococcus aureus or Escherichia coli to penicillin was around 90%; in contrast, the resistance rate to vancomycin, linezolid or imipenem was low (<20%). A large percentage of patients were treated with cephalosporins and fluoroquinolones, while vancomycin and imipenem were also included to treat drug-resistant pathogens. Over half of the hospitalizations (58.43%, n = 336) experienced treatment modifications. The cost to patients with antibiotic modifications was relatively higher than to those without. In conclusion, our study offers an analysis of the disease characteristics, microbiological diagnoses, treatment patterns and clinical outcomes of cSSTI in four hospitals in Guangdong Province, and sheds lights on the current clinical management of cSSTI in China.