UNASSIGNED: We conducted an electronic medical record-based retrospective analysis of patients with VGS bacteraemia admitted to our hospital between January 2012 to December 2021. Blood cultures were incubated by BacT/ALERT system and bacterial identification and susceptibility testing were done by using the VITEK 2 microbial identification system. Susceptibility test reporting was as per Clinical and Laboratory Standards Institute (CLSI) guidelines. The incidence, clinical profile, source of bacteraemia, co-morbidities and antimicrobial resistance among VGS bacteraemia were analyzed.
UNASSIGNED: VGS were isolated in 219 patients, accounting for 3.2% of positive blood cultures during the period studied. The median age of the patients was 58 years and 69% were males. Diabetes mellitus was the most common co-morbidity (55%) followed by chronic kidney disease and chronic liver disease. Patients with haematological malignancy and neutropenia were few. Intra-abdominal infections were the most common source of infection and was noted in 26%. Infective endocarditis was diagnosed in only 10% of the cases. Streptococcus mitis was the most common species isolated followed by S. gallolyticus and S. sanguinis. 9.58% of the isolates could not be identified up to the species level. Overall penicillin susceptibility was 71% and ceftriaxone susceptibility was 92%, with individual species variation. In-hospital mortality was 19%.
UNASSIGNED: VGS are an important cause of bacteraemia and was associated with 19% mortality in our study. High rates of penicillin and ceftriaxone resistance are a reason of concern. Molecular diagnostics like matrix assisted laser desorption ionization-time of flight (MALDI-TOF) identification must be increasingly applied for species identification considering that a substantial number of isolates were not identified to species level.
■我们对2012年1月至2021年12月我院收治的VGS菌血症患者进行了基于电子病历的回顾性分析。血培养物用BacT/ALERT系统孵育,用VITEK2微生物鉴定系统进行细菌鉴定和药敏试验。药敏试验报告按照临床和实验室标准协会(CLSI)指南。发病率,临床资料,菌血症的来源,分析了VGS菌血症的共病和耐药性。
■在219例患者中分离出VGS,占研究期间血培养阳性的3.2%。患者的中位年龄为58岁,69%为男性。糖尿病是最常见的合并症(55%),其次是慢性肾脏疾病和慢性肝病。血液系统恶性肿瘤和中性粒细胞减少症的患者很少。腹腔内感染是最常见的感染源,占26%。仅在10%的病例中诊断出感染性心内膜炎。中炎链球菌是最常见的分离物种,其次是溶胆囊链球菌和血链球菌。9.58%的分离株无法达到物种水平。青霉素的总体敏感性为71%,头孢曲松的敏感性为92%,与个别物种的变异。住院死亡率为19%。
■VGS是菌血症的重要原因,在我们的研究中与19%的死亡率相关。青霉素和头孢曲松的高耐药率是令人担忧的原因。考虑到大量分离株未被鉴定到物种水平,必须越来越多地应用分子诊断,例如基质辅助激光解吸电离飞行时间(MALDI-TOF)鉴定。