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: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。