Trends in the Bacterial Prevalence and Antibiotic Resistance Patterns in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Hospitalized Patients in South India.
Trends in the Bacterial Prevalence and Antibiotic Resistance Patterns in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Hospitalized Patients in South India.
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DOI：
10.3390/antibiotics11111577
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发表时间：
2022-11-09
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影响因子：
--
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中科院分区：
文献类型：
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慢性阻塞性肺疾病（AECOPD）患者中抗微生物药物耐药细菌的恶化导致死亡率和发病率升高。我们检查了AECOPD中细菌有机体的患病率和耐药趋势。在这项回顾性研究中，2016年1月至2020年12月，在3027例AECOPD患者中，有432例（14.3%）进行了细菌分离。在调整了年龄、性别和合并症的影响后，采用回归和广义估计方程（GEE）分析了5年内耐药模式的趋势。常见的有肺炎克雷伯菌（32.4%）、铜绿假单胞菌（17.8%）、鲍曼不动杆菌（14.4%）、大肠杆菌（10.4%）和金黄色葡萄球菌（2.5%）。我们观察到ICU住院的AECOPD患者（87.8%）和非ICU患者（86.5%）的耐药水平较高。Cox比例风险分析发现，鲍曼不动杆菌感染和女性性别是死亡率的独立预测因素。鲍曼不动杆菌的死亡几率比肺炎克雷伯菌高2.64（95%可信区间（CI）： 1.08-6.43）。女性的死亡几率比男性高2.89 （95% CI: 1.47-5.70）。细菌AECOPD的高比例是由耐药菌引起的。女性耐药呈上升趋势。
Exacerbation due to antimicrobial-drug-resistant bacteria among chronic obstructive pulmonary disease (AECOPD) patients contributes to mortality and morbidity. We examined the prevalence of the bacterial organisms and trends in drug resistance in AECOPD. In this retrospective study, between January 2016 to December 2020, among 3027 AECOPD patients, 432 (14.3%) had bacteria isolated. The regression and generalized estimating equations (GEE) were used for trends in the resistance patterns over five years, adjusting for age, gender, and comorbidities. Klebsiella pneumoniae (32.4%), Pseudomonas aeruginosa (17.8%), Acinetobacter baumannii (14.4%), Escherichia coli (10.4%), and Staphylococcus aureus (2.5%) were common. We observed high levels of drug resistance in AECOPD patients admitted to ICU (87.8%) and non-ICU (86.5%). A Cox proportional hazard analysis, observed infection with Acinetobacter baumannii and female sex as independent predictors of mortality. Acinetobacter baumannii had 2.64 (95% confidence interval (CI): 1.08–6.43) higher odds of death, compared to Klebsiella pneumoniae. Females had 2.89 (95% CI: 1.47–5.70) higher odds of death, compared to males. A high proportion of bacterial AECOPD was due to drug-resistant bacteria. An increasing trend in drug resistance was observed among females.
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影响因子：
2.3
作者：
Crisafulli E;Barbeta E;Ielpo A;Torres A
通讯作者：
Torres A
影响因子：
14.2
作者：
Magiorakos, A. -P.;Srinivasan, A.;Monnet, D. L.
通讯作者：
Monnet, D. L.
影响因子：
--
作者：
Jones, Nichola;Mitchell, Jessica;Cooke, Paul;Baral, Sushil;Arjyal, Abriti;Shrestha, Ashim;King, Rebecca
通讯作者：
King, Rebecca
影响因子：
3.7
作者：
Ekström MP;Jogréus C;Ström KE
通讯作者：
Ström KE
影响因子：
0.9
作者：
Kuwal, Ashok;Joshi, Vinod;Purohit, Gopal
通讯作者：
Purohit, Gopal