Risk factors for antibiotic-resistant infection and treatment outcomes among hospitalized patients transferred from long-term care facilities: Does antimicrobial choice make a difference?
Risk factors for antibiotic-resistant infection and treatment outcomes among hospitalized patients transferred from long-term care facilities: Does antimicrobial choice make a difference?
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DOI：
10.1086/368081
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发表时间：
2003-03-15
影响因子：
11.8
通讯作者：
Trenholme, G
中科院分区：
文献类型：
--
作者：
Toubes, E;Singh, K;Trenholme, G
对153例从长期护理机构转移到急性护理医院的患者进行了一项前瞻性观察性研究，这些患者患有微生物学确诊的感染，以确定与耐药菌（ARB）分离相关的风险因素，结局和资源使用。80例患者（52%）感染ARB。在多变量逻辑分析中，饲管（优势比，3.0）或多种微生物感染（优势比，4.6）的存在与ARB的分离有关。49%的ARB感染患者接受了最初的抗生素治疗方案，他们的分离株对该方案不敏感。51%的患者在住院期间改变了抗生素治疗方案。对于这些患者，住院时间、抗生素治疗天数和住院费用明显较高。然而，ARB感染和初始治疗方案的适当性与结局或资源使用均无显著相关。
A prospective observational study of 153 patients transferred from long-term care facilities and admitted to acute-care hospitals who had microbiologically confirmed infections was undertaken to determine the risk factors, outcomes, and resource use associated with isolation of antibiotic-resistant bacteria (ARB). Eighty patients (52%) were infected with ARB. In multivariable logistic analysis, the presence of a feeding tube (odds ratio, 3.0) or polymicrobial infection (odds ratio, 4.6) was associated with isolation of ARB. Forty-nine percent of patients infected with ARB received an initial antibiotic regimen to which their isolate was not susceptible. Fifty-one percent of all patients had a change in their antibiotic regimen during their hospital course. For these patients, length of stay, number of days of antibiotic therapy, and cost of hospitalization were significantly higher. However, neither infection with ARB nor appropriateness of initial treatment regimen was significantly related to outcome or resource use.