Abstract：
BACKGROUND: Non-fermenting Gram-negative bacilli (NFGNB) other than Pseudomonas aeruginosa and Acinetobacter baumannii complex are pathogens of interest due to their ability to cause health-care associated infections and display complex drug resistance phenotypes. However, their clinical and microbiological landscape is still poorly characterized.
METHODS: Observational retrospective study including all hospitalized patients presenting with a positive positive blood culture (BC) episode caused by less common NFGNB over a four-year period (January 2020-December 2023). Clinical-microbiological features and factors associated with mortality were investigated.
RESULTS: Sixty-six less common NFGNB isolates other than Pseudomonas and Acinetobacter species causing 63 positive BC episodes were recovered from 60 patients. Positive BC episodes were predominantly sustained by Stenotrophomonas maltophilia (49.2%) followed by Achromobacter species (15.9%) that exhibited the most complex resistance phenotype. Positive BC episodes had bloodstream infection criteria in 95.2% of cases (60 out 63), being intravascular device (30.2%) and respiratory tract (19.1%) the main sources of infection. Fourteen-day, 30-day, and in-hospital mortality rates were 6.4%, 9.5%, and 15.9%, respectively. The longer time from admission to the positive BC episode, older age, diabetes, admission due to sepsis, and higher Charlson Comorbidity Index were identified as the main predictors of in-hospital mortality.
CONCLUSIONS: Positive BC episodes sustained by NFGNB other than Pseudomonas and Acinetobacter species were predominantly sustained by Stenotrophomonas maltophilia and Achromobacter species, having bloodstream infection criteria in the vast majority of cases. Factors that have emerged to be associated with mortality highlighted how these species may have more room in prolonged hospitalisation and at the end of life for patients with chronic organ diseases.
METHODS: Observational retrospective study including all hospitalized patients presenting with a positive positive blood culture (BC) episode caused by less common NFGNB over a four-year period (January 2020-December 2023). Clinical-microbiological features and factors associated with mortality were investigated.
RESULTS: Sixty-six less common NFGNB isolates other than Pseudomonas and Acinetobacter species causing 63 positive BC episodes were recovered from 60 patients. Positive BC episodes were predominantly sustained by Stenotrophomonas maltophilia (49.2%) followed by Achromobacter species (15.9%) that exhibited the most complex resistance phenotype. Positive BC episodes had bloodstream infection criteria in 95.2% of cases (60 out 63), being intravascular device (30.2%) and respiratory tract (19.1%) the main sources of infection. Fourteen-day, 30-day, and in-hospital mortality rates were 6.4%, 9.5%, and 15.9%, respectively. The longer time from admission to the positive BC episode, older age, diabetes, admission due to sepsis, and higher Charlson Comorbidity Index were identified as the main predictors of in-hospital mortality.
CONCLUSIONS: Positive BC episodes sustained by NFGNB other than Pseudomonas and Acinetobacter species were predominantly sustained by Stenotrophomonas maltophilia and Achromobacter species, having bloodstream infection criteria in the vast majority of cases. Factors that have emerged to be associated with mortality highlighted how these species may have more room in prolonged hospitalisation and at the end of life for patients with chronic organ diseases.
摘要：
背景：铜绿假单胞菌和鲍曼不动杆菌复合体以外的非发酵革兰氏阴性杆菌（NFGNB）是感兴趣的病原体，因为它们能够引起医疗保健相关感染并显示复杂的耐药性表型。然而,他们的临床和微生物学景观仍然缺乏表征。
方法：观察性回顾性研究，包括所有住院患者，在4年期间（2020年1月至2023年12月），因NFGNB不太常见而出现血培养阳性（BC）事件。研究了临床微生物学特征和与死亡率相关的因素。
结果：从60例患者中恢复了除假单胞菌和不动杆菌以外的66种较不常见的NFGNB分离株，导致63例阳性BC发作。阳性BC发作主要由嗜麦芽窄食单胞菌（49.2％）维持，其次是表现出最复杂的耐药表型的无色杆菌（15.9％）。阳性BC发作在95.2%的病例中有血流感染标准（60/63），血管内装置(30.2%)和呼吸道(19.1%)是主要感染源。十四天,30天,住院死亡率为6.4%，9.5%,和15.9%，分别。从入院到BC阳性发作的时间越长，年龄较大,糖尿病,因脓毒症入院,和较高的Charlson合并症指数被确定为院内死亡率的主要预测因子。
结论：由除假单胞菌和不动杆菌属以外的NFGNB维持的阳性BC发作主要由嗜麦芽窄食单胞菌和嗜铬菌属维持，在绝大多数病例中具有血流感染标准。与死亡率相关的因素突显了这些物种如何在长期住院和慢性器官疾病患者的生命终结中有更多的空间。
方法：观察性回顾性研究，包括所有住院患者，在4年期间（2020年1月至2023年12月），因NFGNB不太常见而出现血培养阳性（BC）事件。研究了临床微生物学特征和与死亡率相关的因素。
结果：从60例患者中恢复了除假单胞菌和不动杆菌以外的66种较不常见的NFGNB分离株，导致63例阳性BC发作。阳性BC发作主要由嗜麦芽窄食单胞菌（49.2％）维持，其次是表现出最复杂的耐药表型的无色杆菌（15.9％）。阳性BC发作在95.2%的病例中有血流感染标准（60/63），血管内装置(30.2%)和呼吸道(19.1%)是主要感染源。十四天,30天,住院死亡率为6.4%，9.5%,和15.9%，分别。从入院到BC阳性发作的时间越长，年龄较大,糖尿病,因脓毒症入院,和较高的Charlson合并症指数被确定为院内死亡率的主要预测因子。
结论：由除假单胞菌和不动杆菌属以外的NFGNB维持的阳性BC发作主要由嗜麦芽窄食单胞菌和嗜铬菌属维持，在绝大多数病例中具有血流感染标准。与死亡率相关的因素突显了这些物种如何在长期住院和慢性器官疾病患者的生命终结中有更多的空间。
