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Abstract：
UNASSIGNED: To determine the clinical features, outcomes, and factors associated with the emergence of colistin-resistant gram-negative rods isolated from patients admitted to intensive care units.
UNASSIGNED: This cross-sectional study was conducted at the intensive care units of Liaquat National Hospital, from April 2019 to February 2020. Gram-negative rods resistant to colistin with minimum inhibitory concentrations ⩾ 4 mcg/mL according to Clinical and Laboratory Standards Institute criteria as reported in cultures were included. Clinical, demographical data and treatment given were recorded and analyzed using SPSS version 25.
UNASSIGNED: A total of 93 patients were included; 58.1% were males. The mean age of patients was 59.48 ± 18.36 years. The most common organism isolated was Klebsiella pneumoniae (91.4%). The most common specimen was the tracheal (62.4%). Ventilator-acquired pneumonia was seen in 38.7%. The most common co-morbid disease seen in patients was diabetes (41%); 77% had a symptomatic infection and were treated with a combination of 2 or more antibiotics, most commonly meropenem plus fosfomycin. The most common susceptible antibiotics were fosfomycin (72%) and tigecycline (50.5%). Mean intensive care unit stay and total duration of hospital stay were prolonged (16.83 ± 12.93 and 23.34 ± 17.52 days, respectively). Forty-eight (62.3%) patients with symptomatic infection with colistin-resistant isolates were treated and discharged, and mortality was seen in 23 (29.9%). A significant association was found between mortality and symptomatic infection, endotracheal intubation with mechanical ventilation (p = 0.003), and a prolonged hospital stay of >20 days (p = 0.041).
UNASSIGNED: Colistin-resistant gram-negative rods pose a significant problem especially in developing countries because of limited therapeutic options. Stringent infection control and comprehensive antimicrobial stewardship programs are needed to overcome this challenge.
UNASSIGNED: This cross-sectional study was conducted at the intensive care units of Liaquat National Hospital, from April 2019 to February 2020. Gram-negative rods resistant to colistin with minimum inhibitory concentrations ⩾ 4 mcg/mL according to Clinical and Laboratory Standards Institute criteria as reported in cultures were included. Clinical, demographical data and treatment given were recorded and analyzed using SPSS version 25.
UNASSIGNED: A total of 93 patients were included; 58.1% were males. The mean age of patients was 59.48 ± 18.36 years. The most common organism isolated was Klebsiella pneumoniae (91.4%). The most common specimen was the tracheal (62.4%). Ventilator-acquired pneumonia was seen in 38.7%. The most common co-morbid disease seen in patients was diabetes (41%); 77% had a symptomatic infection and were treated with a combination of 2 or more antibiotics, most commonly meropenem plus fosfomycin. The most common susceptible antibiotics were fosfomycin (72%) and tigecycline (50.5%). Mean intensive care unit stay and total duration of hospital stay were prolonged (16.83 ± 12.93 and 23.34 ± 17.52 days, respectively). Forty-eight (62.3%) patients with symptomatic infection with colistin-resistant isolates were treated and discharged, and mortality was seen in 23 (29.9%). A significant association was found between mortality and symptomatic infection, endotracheal intubation with mechanical ventilation (p = 0.003), and a prolonged hospital stay of >20 days (p = 0.041).
UNASSIGNED: Colistin-resistant gram-negative rods pose a significant problem especially in developing countries because of limited therapeutic options. Stringent infection control and comprehensive antimicrobial stewardship programs are needed to overcome this challenge.
摘要：
未经授权：为了确定临床特征，结果，以及与从重症监护病房患者中分离出的粘菌素抗性革兰氏阴性棒的出现相关的因素。
UNASSIGNED：这项横断面研究是在Liaquat国立医院的重症监护病房进行的，从2019年4月到2020年2月。根据临床和实验室标准研究所的标准，包括培养物中报道的对粘菌素具有最低抑制浓度的革兰氏阴性棒4mcg/mL。临床,使用SPSS25版记录和分析人口统计学数据和给予的治疗。
未经批准：共纳入93例患者，58.1%为男性。患者平均年龄为59.48±18.36岁。最常见的细菌是肺炎克雷伯菌（91.4％）。最常见的标本是气管（62.4％）。呼吸机获得性肺炎占38.7%。患者中最常见的合并症是糖尿病（41％）；77％的患者有症状感染，并接受了2种或更多种抗生素的组合治疗。最常见的是美罗培南加磷霉素。最常见的敏感抗生素是磷霉素（72％）和替加环素（50.5％）。平均重症监护病房住院时间和总住院时间延长(16.83±12.93和23.34±17.52天,分别)。48例(62.3%)有症状感染粘菌素耐药菌株的患者获得治疗后出院,死亡率为23例(29.9%)。发现死亡率和症状性感染之间存在显着关联，气管插管机械通气（p=0.003），住院时间>20天（p=0.041）。
UASSIGNED：由于治疗选择有限，粘菌素抗性革兰氏阴性棒尤其在发展中国家造成了重大问题。需要严格的感染控制和全面的抗菌药物管理计划来克服这一挑战。
UNASSIGNED：这项横断面研究是在Liaquat国立医院的重症监护病房进行的，从2019年4月到2020年2月。根据临床和实验室标准研究所的标准，包括培养物中报道的对粘菌素具有最低抑制浓度的革兰氏阴性棒4mcg/mL。临床,使用SPSS25版记录和分析人口统计学数据和给予的治疗。
未经批准：共纳入93例患者，58.1%为男性。患者平均年龄为59.48±18.36岁。最常见的细菌是肺炎克雷伯菌（91.4％）。最常见的标本是气管（62.4％）。呼吸机获得性肺炎占38.7%。患者中最常见的合并症是糖尿病（41％）；77％的患者有症状感染，并接受了2种或更多种抗生素的组合治疗。最常见的是美罗培南加磷霉素。最常见的敏感抗生素是磷霉素（72％）和替加环素（50.5％）。平均重症监护病房住院时间和总住院时间延长(16.83±12.93和23.34±17.52天,分别)。48例(62.3%)有症状感染粘菌素耐药菌株的患者获得治疗后出院,死亡率为23例(29.9%)。发现死亡率和症状性感染之间存在显着关联，气管插管机械通气（p=0.003），住院时间>20天（p=0.041）。
UASSIGNED：由于治疗选择有限，粘菌素抗性革兰氏阴性棒尤其在发展中国家造成了重大问题。需要严格的感染控制和全面的抗菌药物管理计划来克服这一挑战。
