Multidrug-resistant Acinetobacter: Risk factors and outcomes in veterans with spinal cord injuries and disorders.
Multidrug-resistant Acinetobacter: Risk factors and outcomes in veterans with spinal cord injuries and disorders.
复制标题
DOI：
10.1016/j.ajic.2017.06.016
复制
发表时间：
2017-11-01
影响因子：
4.9
通讯作者：
Evans CT
中科院分区：
文献类型：
--
作者：
Ramanathan S;Suda KJ;Fitzpatrick MA;Poggensee L;LaVela SL;Burns SP;Evans CT
多药耐药（MDR）不动杆菌日益受到关注，并已被疾病控制和预防中心确定为严重威胁。然而，关于脊髓损伤和疾病（SCI/D）患者中耐多药不动杆菌的信息很少。因此，本研究的目的是确定SCI/D退伍军人中MDR不动杆菌的危险因素，并评估其预后。这是一项回顾性队列研究，从2012年1月1日至2013年12月31日，使用国家退伍军人事务部（VA）医疗遭遇和微生物学数据。571例患者共检出773个不动杆菌培养物，其中58.9%为耐多药。住院培养、男性、痰液及其他标本类型、培养前90天内使用抗生素、压疮被确定为耐多药不动杆菌的独立预测因素。既往使用抗生素者耐多药不动杆菌的发生率最高（OR=7.27; 95% CI: 2.59-20.54）。30天死亡率为5.3%。耐多药、培养前90天机械通气史、癌症均为30天死亡率的独立危险因素。应加强努力，强调抗菌剂管理的重要性，以改善感染控制，帮助限制不动杆菌在医疗保健机构的传播。
Multi-drug resistant (MDR) Acinetobacter is a growing concern and has been identified as a serious threat by the Centers of Disease Control and Prevention. However there is little information on MDR Acinetobacter in individuals with spinal cord injuries and disorders (SCI/D). Therefore, the objective of this study was to identify risk factors for, and assess outcomes of MDR Acinetobacter in Veterans with SCI/D. This was a retrospective cohort study from January 1, 2012 to December 31, 2013 using national Veterans Affairs (VA) medical encounter and microbiology data. A total of 773 Acinetobacter cultures were identified in 571 patients, of which 58.9% were MDR. Inpatient culture, male gender, sputum and other specimen type, receipt of antibiotics within 90 days before culture date, and pressure ulcers were identified as independent predictors of MDR Acinetobacter. Highest odds of MDR Acinetobacter was seen with previous antibiotic use (OR=7.27; 95% CI: 2.59-20.54). 30-day mortality was 5.3% in this study. MDR, previous mechanical ventilation 90 days before the culture, and cancer were all independent risk factors for 30 day mortality. There should be increased efforts to highlight the importance of antimicrobial stewardship in order to improve infection control to help limit spread of Acinetobacter in healthcare settings.
登录
查看更多内容
DOI：
10.1007/s10096-008-0473-y
发表时间：
2008-07-01
影响因子：
4.5
作者：
Wareham, D. W.;Bean, D. C.;Millar, M.
通讯作者：
Millar, M.
影响因子：
14.2
作者：
Freire, M. P.;de Oliveira Garcia, D.;Abdala, E.
通讯作者：
Abdala, E.
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：
4.9
作者：
Mylotte, JM;Kahler, L;Goodnough, S
通讯作者：
Goodnough, S
影响因子：
5.2
作者：
Lim, Ching Jou;Cheng, Allen C.;Peleg, Anton Y.
通讯作者：
Peleg, Anton Y.