Corynebacterium striatum

纹状体棒状杆菌
  • 文章类型: Journal Article
    这项研究的目的是评估纹状体棒状杆菌假体关节感染(PJI)的发生率,以确定最近是否发生了增加。此外,我们对纹状体梭菌保存的分离株进行了药敏试验,以确定这些感染的抗生素选择.
    从2017年1月1日至2021年1月1日对PJI病例进行回顾性审查,与1/2021至7/2022进行比较,以确定每个时间点发生了多少纹状体梭菌病例。从这些案例中,人口统计,记录纹状体梭菌PJI的结局和危险因素.测试了这些病例中保存的临床分离株对不同抗生素的敏感性。
    在过去的16个月中,在一个机构中,纹状体C.PJI病例的比例在统计学上显着增加(1.98至7.84,p=0.0489)。慢性伤口和暴露于达托霉素与大多数这些病例有关。临床分离株的药敏试验显示对万古霉素的敏感性均匀,利奈唑胺和达巴万辛.环丙沙星的耐药性均匀,四环素和强力霉素。有趣的是,在暴露于达托霉素过夜后,85.7%的分离株显示出诱导型达托霉素抗性。
    C.纹状体是一种新兴的PJI病原体。对于临床医生来说,重要的是认识到这种病原体可能具有可诱导的高水平达托霉素抗性,并且达托霉素可能不是这些感染的可靠抗生素。虽然万古霉素和利奈唑胺是用于这些感染的传统抗生素,其他抗生素如达巴万金,也可能有效用,但是需要更多的研究来确定这种抗生素在纹状体梭菌感染中的有效性。
    UNASSIGNED: The aim of this study was to assess the incidence of Corynebacterium striatum prosthetic joint infections (PJI) to determine if an increase has occurred recently. Moreover, susceptibility testing was conducted on C. striatum preserved isolates to determine antibiotic options for these infections.
    UNASSIGNED: Retrospective review of PJI cases was conducted from 1/2017 through 1/2021 compared to 1/2021 through 7/2022 to determine how many cases of C. striatum have occurred for each of these time points. From these cases, demographics, outcomes and risk factors for C. striatum PJI were recorded. The preserved clinical isolates from these cases were tested for susceptibility to different antibiotics.
    UNASSIGNED: A statistically significant increase in the proportion of C. striatum PJI cases (1.98 to 7.84, p=0.0489) has occurred over the past 16 months at a single institution. Chronic wounds and exposure to daptomycin were associated with the majority of these cases. Susceptibility testing of the clinical isolates showed uniform susceptibility to vancomycin, linezolid and dalbavancin. Uniform resistance was seen with ciprofloxacin, tetracycline and doxycycline as well. Interestingly, 85.7% of the isolates displayed inducible daptomycin resistance after overnight exposure to daptomycin.
    UNASSIGNED: C. striatum is an emerging PJI pathogen. It is important for clinicians to be cognizant that this pathogen can have inducible high level daptomycin resistance and that daptomycin is likely not a reliable antibiotic for these infections. While vancomycin and linezolid are the traditional antibiotics to use in these infections, other antibiotics such as dalbavancin, may also have utility, but more research is needed to determine the effectiveness of this antibiotic in C. striatum infections.
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  • 文章类型: Case Reports
    纹状体棒状杆菌偶尔会引起医院感染,如导管相关性血流感染和肺炎;纹状体相关性感染性心内膜炎或脓毒性关节炎并不常见。我们介绍了一例85岁的女性,该女性患有由纹状体C.引起的天然瓣膜感染性心内膜炎和天然肩关节化脓性关节炎。患者因发热和右肩疼痛病史10天入院。她没有人工装置植入的病史,损伤,关节穿刺术,或住院治疗。体格检查发现结膜瘀斑,心脏收缩期杂音,右肩关节肿胀。在两组血液培养物中观察到纹状体。经食道超声心动图显示右主动脉冠状尖有植被。右肩处的关节穿刺术吸出的化脓液和培养物中检测到纹状体梭菌。患者被诊断为由纹状体梭菌引起的感染性心内膜炎和化脓性关节炎,根据抗菌药物敏感性试验结果给予氨苄西林.病人的情况最初是稳定的;然而,她在第56天出现肺充血,最终死亡。尸检显示主动脉左冠状动脉尖穿孔。纹状体梭菌可引起天然瓣膜心内膜炎和天然关节化脓性关节炎。
    Corynebacterium striatum occasionally causes nosocomial infections, such as catheter-related bloodstream infection and pneumonia; however, C. striatum-related infective endocarditis or septic arthritis is uncommon. We present the case of an 85-year-old woman with infective endocarditis at the native valve and septic arthritis at the native shoulder joint caused by C. striatum. The patient was admitted for a 10-day history of fever and right shoulder pain. She had no history of artificial device implantation, injury, arthrocentesis, or hospitalization. A physical examination revealed conjunctival petechiae, a systolic heart murmur, and right shoulder joint swelling. C. striatum was observed in two blood culture sets. Transesophageal echocardiography revealed vegetation in the right aortic coronary cusp. Arthrocentesis at the right shoulder aspirated pyogenic fluid and C. striatum was detected in the culture. The patient was diagnosed with infective endocarditis and septic arthritis caused by C. striatum, and ampicillin was administered based on antimicrobial susceptibility test results. The patient\'s condition was initially stable; however, she developed pulmonary congestion on day 56 and eventually died. An autopsy demonstrated perforation of the aortic left coronary cusp with vegetation. C. striatum may cause native valve endocarditis and native joint septic arthritis.
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  • 文章类型: Journal Article
    为了研究纹状体棒状杆菌作为医院病原体感染难以愈合的外周伤口,比如皮肤伤口,软组织脓肿和骨髓炎。截至2023年,医学界已收到有关出现全身和中枢感染风险的警报;另一方面,有关外周皮肤区域的文献仍然很少。
    在这项研究中,对两组感染相似病变的患者进行比较:一组存在棒状杆菌,另一个没有。
    总共,从62名患者和131个样品中培养纹状体棒状杆菌。纹状体棒状杆菌感染与以下疾病的存在密切相关:足溃疡;静脉性腿部溃疡;步行改变和/或足负荷改变;外周血管和动脉疾病;住院;恶性肿瘤;脊髓损伤;以及最近使用抗生素(所有关联的p<0.05)。与非纹状体棒状杆菌组患者相比,纹状体棒状杆菌患者的总体生存率较低(28.6对31.6个月,分别为;p=0.0285)。多因素分析显示纹状体棒状杆菌感染是预后不良的独立因素(p<0.0001)。
    鉴于我们的研究结果,纹状体棒状杆菌似乎是感染外周组织并使伤口愈合复杂化的重要机会病原体。鉴于其众多且令人担忧的毒力因素(如多药耐药性和生物膜产生),在医院和门诊环境中,专业伤口护理提供者应特别注意这种病原体。
    UNASSIGNED: To investigate Corynebacterium striatum as a nosocomial pathogen infecting hard-to-heal peripheral wounds, such as skin wounds, soft tissue abscesses and osteomyelitis. As of 2023, the medical community were alerted against the risk of emerging systemic and central infections; on the other hand literature on peripheral cutaneous regions is still scarce.
    UNASSIGNED: In this study, two groups of patients with similar lesions which were infected were compared: one group with the presence of the coryneform rod, the other without.
    UNASSIGNED: In total, Corynebacterium striatum was cultured from 62 patients and 131 samples. Corynebacterium striatum infection correlated well with the presence of: foot ulcer; venous leg ulcer; altered ambulation and/or altered foot loading; peripheral vascular and arterial disease; hospitalisation; malignancy; spinal cord injury; and recent administration of antibiotics (p<0.05 for all associations). Patients with Corynebacterium striatum had a lower overall survival rate compared to patients in the non-Corynebacterium striatum group (28.6 versus 31.6 months, respectively; p=0.0285). Multivariate analysis revealed that Corynebacterium striatum infection was an independent factor for poor prognosis (p<0.0001).
    UNASSIGNED: In view of the findings of our study, Corynebacterium striatum appears to be an important opportunistic pathogen infecting peripheral tissues and complicating wound healing. Given its numerous and worrying virulence factors (such as multidrug resistance and biofilm production), particular attention should be given to this pathogen by professional wound care providers in nosocomial and outpatient environments.
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  • 文章类型: Journal Article
    目的:纹状体棒状杆菌(CS)是一种新兴的糖尿病足感染微生物,目前对其研究较少。目的是分析糖尿病足患者CS骨髓炎的危险因素(RF)。
    方法:2015年至2021年在糖尿病足单位进行了病例对照研究。包括44例因CS引起的骨髓炎患者(病例)和44例因不同微生物引起的骨髓炎患者(对照)。
    结果:外周动脉疾病(OR:2.8,p=0.037),心房颤动(OR:3.7,p=0.034),缺血性糖尿病足(OR:3.3,p=0.020)和既往长期抗生素治疗超过14天(OR:3.4,p=0.012)被确定为CS引起的骨髓炎的RF.当进行多变量分析时,>14天的抗生素治疗是独立的RF(OR:3.46;p=0.017)。
    结论:先前接受超过14天的抗生素治疗是糖尿病足患者CS骨髓炎的独立且具有统计学意义的RF。
    Corynebacterium striatum (CS) is an emerging micro-organism in diabetic foot infection for which there are currently few studies. The objective was to analyze the risk factors (RF) related to CS osteomyelitis in patients with diabetic foot.
    A case-control study was conducted in the Diabetic Foot Unit between 2015 and 2021. Forty-four patients with osteomyelitis due to CS (cases) and 44 patients with osteomyelitis due a different micro-organism (controls) were included.
    Peripheral artery disease (OR: 2.8, p = 0.037), atrial fibrillation (OR: 3.7, p = 0.034), ischemic diabetic foot (OR: 3.3, p = 0.020) and previous prolonged antibiotic therapy more than 14 days (OR: 3.4, p = 0.012) were identified as RF for osteomyelitis due to CS. When performing the multivariate analysis antibiotic therapy >14 days was independent RF (OR: 3.46; p = 0.017).
    Previous antibiotic therapy received more than 14 days is an independent and statistically significant RF for CS osteomyelitis in patients with diabetic foot.
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  • 文章类型: Journal Article
    基因组规模的代谢模型(GEM)是特定于生物体的知识库,可用于揭示致病性或改善生物技术应用中特定代谢物的生产。然而,在体外环境中细菌增殖预测的有效性几乎没有研究。方法:本工作结合了计算机和体外方法来创建和管理纹状体棒杆菌的菌株特异性基因组尺度代谢模型。结果:我们介绍了五个新创建的高质量菌株特异性基因组尺度代谢模型(GEMs),满足所有当代标准和要求。所有这些模型都使用社区标准测试套件代谢模型测试(MEMOTE)进行了基准测试,并通过实验室实验进行了验证。对于这些模型的策展,软件基础设施精炼GEM被开发为并行地对这些模型进行工作,并符合GEM的质量标准。实验数据证实了模型预测,并开发了基于倍增时间的新比较度量来量化细菌生长。讨论:未来的建模项目可以依赖于建议的软件,这与特定的环境条件无关。基于增长率计算的验证方法现在是可访问的,并且与生物学问题密切相关。精选的模型可以通过BioModels和GitHub存储库免费获得,并且可以使用。开源软件refineGEM可从https://github.com/draeger-lab/refinegems获得。
    Introduction: Genome-scale metabolic models (GEMs) are organism-specific knowledge bases which can be used to unravel pathogenicity or improve production of specific metabolites in biotechnology applications. However, the validity of predictions for bacterial proliferation in in vitro settings is hardly investigated. Methods: The present work combines in silico and in vitro approaches to create and curate strain-specific genome-scale metabolic models of Corynebacterium striatum. Results: We introduce five newly created strain-specific genome-scale metabolic models (GEMs) of high quality, satisfying all contemporary standards and requirements. All these models have been benchmarked using the community standard test suite Metabolic Model Testing (MEMOTE) and were validated by laboratory experiments. For the curation of those models, the software infrastructure refineGEMs was developed to work on these models in parallel and to comply with the quality standards for GEMs. The model predictions were confirmed by experimental data and a new comparison metric based on the doubling time was developed to quantify bacterial growth. Discussion: Future modeling projects can rely on the proposed software, which is independent of specific environmental conditions. The validation approach based on the growth rate calculation is now accessible and closely aligned with biological questions. The curated models are freely available via BioModels and a GitHub repository and can be used. The open-source software refineGEMs is available from https://github.com/draeger-lab/refinegems.
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  • 文章类型: Case Reports
    背景:我们在此描述了噬血细胞性淋巴组织细胞增生症(HLH)和组织细胞坏死性淋巴结炎的共存,或者称为菊池病(KD),继发于纹状体棒状杆菌引起的血液透析导管相关性血流感染(BSI)。
    方法:一名维持性血液透析患者出现持续发热,随后从导管尖端和外周血培养物中鉴定出纹状体棒状杆菌。在缓解BSI期间,然而,他的发烧有增无减,随后进一步检查发现血小板减少症,高铁蛋白血症,高甘油三酯血症,低NK细胞活性和血清CD25水平激增。此外,骨髓和淋巴结活检检测到细胞吞噬和KD的组织病理学证据,分别。在这些异常情况下,我们考虑了标题限制的诊断,患者最终从地塞米松而不是抗生素治疗中康复.始终如一,出院后两个月,他的血清CD25水平和NK细胞活性的异常已消退。
    结论:可以说,这次相遇提供了一个独特的机会来解开免疫生物学中的主要致病级联,使这三个实体成为一个疾病的连续体。因此,我们的工作可能会增加对一般严重感染继发HLH和/或KD的新认识,尤其是在肾脏疾病患者中细胞因子过度释放.由此产生的早期诊断对于启动适当的治疗和改善患有这些具有挑战性和潜在威胁生命的疾病的患者的生存至关重要。
    We herein described the coexistence of hemophagocytic lymphohistiocytosis (HLH) and histiocytic necrotizing lymphadenitis, alternatively known as the Kikuchi disease (KD), secondary to hemodialysis catheter-related bloodstream infection (BSI) caused by Corynebacterium striatum.
    A patient on maintenance hemodialysis had developed persistent fever and Corynebacterium striatum was subsequently identified from the culture of both catheter tip and peripheral blood. During mitigation of the BSI, however, his fever was unabated and ensuing workup further found thrombocytopenia, hyperferritinemia, hypertriglyceridemia, low NK cell activity and a surge in serum CD25 levels. Moreover, biopsy of the bone marrow and lymph node detected histopathological evidence of hemophagocytosis and KD, respectively. Upon these abnormalities, the title-bound diagnosis was considered and the patient was eventually recovered from the treatment of dexamethasone instead of antibiotics. Consistently, aberrations in his serum CD25 levels and NK cell activity had subsided two months after discharge.
    Arguably, this encounter offered a unique chance to unravel the principal pathogenic cascade in immunobiology that made the three entities one disease continuum. As such, our work may add new understandings of HLH and/or KD secondary to severe infections in general and excessive release of cytokines in particular among patients with kidney diseases. The resultant early diagnosis is crucial to initiate appropriate treatment and improve the survival of patients with these challenging and potentially life-threatening disorders.
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  • 文章类型: Journal Article
    背景:在过去的二十年中,已越来越多地从临床培养物中分离出纹状体棒状杆菌,大多数分离株对最后手段的抗微生物耐药性(AMR)增加。泛基因组学领域的进展将有助于理解以前被认为是共生菌的此类细菌的临床意义,为确定新的药物靶标和控制策略铺平了道路。
    方法:我们使用310个纹状体的基因组序列构建了一个全基因组。使用三种工具进行全基因组分析,包括Roary,海盗,还有PEPPAN.已经研究了与核心基因组系统发育有关的AMR基因和毒力因子。基因组群岛(GI),积分,和前噬菌体区域已经被详细探索。
    结果:泛基因组范围在总共5253-5857个基因和2070-1899个核心基因簇之间。一些抗微生物药物抗性基因已经在核心基因组部分被鉴定,但是它们中的大多数位于可有可无的基因组中。此外,致病性棒状杆菌中描述的一些众所周知的毒力因子位于可有可无的基因组中。总共鉴定了115种噬菌体,只有44个完整的噬菌体区域。
    结论:本研究提供了纹状体梭菌的详细比较性pangenome报告。该物种显示出生长非常缓慢的全基因组,核心基因组中的基因数量相对较高,从而导致较低的基因组变异。携带AMR和毒力元件的噬菌体元件在该物种中似乎很少见。GI似乎在动员物种中的抗生素抗性基因中起着重要作用,并且整合子在物种中以50%的频率出现。控制策略应针对核心基因组上携带的毒力和抗性决定子以及附件基因组中经常发生的那些。
    Over the past two decades, Corynebacterium striatum has been increasingly isolated from clinical cultures with most isolates showing increased antimicrobial resistance (AMR) to last resort agents. Advances in the field of pan genomics would facilitate the understanding of the clinical significance of such bacterial species previously thought to be among commensals paving the way for identifying new drug targets and control strategies.
    We constructed a pan-genome using 310 genome sequences of C. striatum. Pan-genome analysis was performed using three tools including Roary, PIRATE, and PEPPAN. AMR genes and virulence factors have been studied in relation to core genome phylogeny. Genomic Islands (GIs), Integrons, and Prophage regions have been explored in detail.
    The pan-genome ranges between a total of 5253-5857 genes with 2070 - 1899 core gene clusters. Some antimicrobial resistance genes have been identified in the core genome portion, but most of them were located in the dispensable genome. In addition, some well-known virulence factors described in pathogenic Corynebacterium species were located in the dispensable genome. A total of 115 phage species have been identified with only 44 intact prophage regions.
    This study presents a detailed comparative pangenome report of C. striatum. The species show a very slowly growing pangenome with relatively high number of genes in the core genome contributing to lower genomic variation. Prophage elements carrying AMR and virulence elements appear to be infrequent in the species. GIs appear to offer a prominent role in mobilizing antibiotic resistance genes in the species and integrons occur at a frequency of 50% in the species. Control strategies should be directed against virulence and resistance determinants carried on the core genome and those frequently occurring in the accessory genome.
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  • 文章类型: Journal Article
    纹状体棒状杆菌是革兰氏阳性细菌,其为直的或略微弯曲的并且不形成孢子。虽然它最初被认为是人类皮肤正常微生物组的一部分,越来越多的研究将其确定为各种慢性疾病的病因,菌血症,和呼吸道感染。然而,尽管它作为病原体越来越重要,病原体种群的遗传特征,如基因组特征和差异,病原体携带的抗性基因和毒力因子的类型及其在人群中的分布知之甚少。为了解决这些知识差距,我们对从不同组织和地理位置分离的314株纹状体梭菌进行了全基因组分析。我们的分析表明纹状体梭菌具有开放的泛基因组,由5692个基因家族组成,包括1845个核心基因家族,2362个附属基因家族,和1485个独特的基因家族。我们还发现纹状体梭菌在不同来源之间表现出高度的多样性,但是从皮肤组织中分离的菌株更保守。此外,通过将菌株与耐药基因数据库(CARD)和病原体毒力因子数据库(VFDB)进行比较,我们鉴定了53个耐药基因和42个毒力因子,分别。我们发现这些基因和因子广泛分布于纹状体,77.7%的菌株携带2个或2个以上的抗性基因,对氨基糖苷类表现出初级抗性,四环素,林可霉素,大环内酯类,和链霉素.毒力因子主要与宿主内的病原体存活有关,铁吸收,pili,和早期生物膜形成。总之,我们的研究提供了对人口多样性的见解,抗性基因,和C的毒力因子。纹状体来自不同的来源。我们的发现可以为未来的诊断研究和临床实践提供信息,预防,以及纹状体梭菌相关疾病的治疗。
    Corynebacterium striatum is a Gram-positive bacterium that is straight or slightly curved and non-spore-forming. Although it was originally believed to be a part of the normal microbiome of human skin, a growing number of studies have identified it as a cause of various chronic diseases, bacteremia, and respiratory infections. However, despite its increasing importance as a pathogen, the genetic characteristics of the pathogen population, such as genomic characteristics and differences, the types of resistance genes and virulence factors carried by the pathogen and their distribution in the population are poorly understood. To address these knowledge gaps, we conducted a pan-genomic analysis of 314 strains of C. striatum isolated from various tissues and geographic locations. Our analysis revealed that C. striatum has an open pan-genome, comprising 5692 gene families, including 1845 core gene families, 2362 accessory gene families, and 1485 unique gene families. We also found that C. striatum exhibits a high degree of diversity across different sources, but strains isolated from skin tissue are more conserved. Furthermore, we identified 53 drug resistance genes and 42 virulence factors by comparing the strains to the drug resistance gene database (CARD) and the pathogen virulence factor database (VFDB), respectively. We found that these genes and factors are widely distributed among C. striatum, with 77.7% of strains carrying 2 or more resistance genes and displaying primary resistance to aminoglycosides, tetracyclines, lincomycin, macrolides, and streptomycin. The virulence factors are primarily associated with pathogen survival within the host, iron uptake, pili, and early biofilm formation. In summary, our study provides insights into the population diversity, resistance genes, and virulence factors ofC. striatum from different sources. Our findings could inform future research and clinical practices in the diagnosis, prevention, and treatment of C. striatum-associated diseases.
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  • 文章类型: Journal Article
    纹状体棒状杆菌是一种新兴的,在全球范围内经常引起医院感染的多药耐药病原体。本研究旨在调查与山西白求恩医院爆发相关的纹状体梭菌菌株的系统发育关系和抗菌素耐药性基因的存在。中国,2021年。从2021年2月12日至2021年4月12日在山西白求恩医院收集了65名纹状体梭菌感染患者的粪便样本。通过16SrRNA和rpoB基因测序鉴定纹状体梭菌分离株。使用电子测试条检查分离物的抗微生物敏感性。采用全基因组测序和生物信息学分析来评估分离株的基因组特征并鉴定抗微生物药物抗性基因。进行结晶紫染色以确定每种分离物的生物膜形成能力。鉴定了总共64个纹状体分离株,并基于单核苷酸多态性分类为4个进化枝。所有分离株均对青霉素耐药,美罗培南,头孢曲松,和环丙沙星,但对万古霉素和利奈唑胺敏感。大多数分离株对四环素也有抗性,克林霉素,和红霉素,敏感性分别为10.77、4.62和7.69%,分别。基因组分析显示分离物中有14个抗菌素抗性基因,包括tetW,ermX,还有sul1.结晶紫染色显示所有分离物在非生物表面形成生物膜。多重耐药纹状体的四个分支在我们的医院传播,可能是由于获得了抗菌素耐药基因。
    Corynebacterium striatum is an emerging, multidrug-resistant pathogen that frequently causes nosocomial infections worldwide. This study aimed to investigate phylogenetic relationship and presence of genes responsible for antimicrobial resistance among C. striatum strains associated with an outbreak at the Shanxi Bethune Hospital, China, in 2021. Fecal samples were collected from 65 patients with C. striatum infection at Shanxi Bethune Hospital between February 12, 2021 and April 12, 2021. C. striatum isolates were identified by 16S rRNA and rpoB gene sequencing. E-test strips were used to examine the antimicrobial susceptibility of the isolates. Whole-genome sequencing and bioinformatics analysis were employed to assess the genomic features and identify antimicrobial resistance genes of the isolates. Crystal violet staining was conducted to determine the ability of biofilm formation of each isolate. A total of 64 C. striatum isolates were identified and categorized into 4 clades based on single nucleotide polymorphisms. All isolates were resistant to penicillin, meropenem, ceftriaxone, and ciprofloxacin but susceptible to vancomycin and linezolid. Most isolates were also resistant to tetracycline, clindamycin, and erythromycin, with susceptibility rates of 10.77, 4.62, and 7.69%, respectively. Genomic analysis revealed 14 antimicrobial resistance genes in the isolates, including tetW, ermX, and sul1. Crystal violet staining showed that all isolates formed biofilms on the abiotic surface. Four clades of multidrug-resistant C. striatum spread in our hospitals possibly due to the acquisition of antimicrobial resistance genes.
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  • 文章类型: Journal Article
    评估靶向抗生素治疗对纹状体棒状杆菌下呼吸道(LRT)感染患者临床结局的影响(C.纹状体)。
    使用10年数据进行了一项新的倾向评分-治疗加权逆概率(IPTW)队列研究。该研究包括同时培养为纹状体C.的呼吸道分泌物阳性的LRT感染患者。主要结局是全因住院死亡率;次要结局包括住院时间,ICU停留时间和通气时间。安全性结果为药物相关血清肌酐(Cr)升高和血小板减少。
    共有339名患者被纳入队列,84(24.78%)开始万古霉素或利奈唑胺治疗。在新的IPTW队列中,有针对性的抗生素治疗不能改善全因死亡率(P=0.632),OR(95%CI)为0.879(0.519-1.488)。此外,靶向抗生素治疗与住院时间无关(P=0.415),ICU住院时间(P=0.945)或通气时间(P=0.885)。与药物相关的高血清Cr(P=0.044)和血小板减少(P=0.038)的副作用不容忽视。
    万古霉素或利奈唑胺对纹状体梭菌LRT感染的临床获益有限,并伴有药物相关的副作用。需要进行前瞻性设计的研究以进一步确认结果。
    UNASSIGNED: To assess the impact of targeted antibiotic therapy on clinical outcomes of patients with lower respiratory tract (LRT) infection with Corynebacterium striatum (C. striatum).
    UNASSIGNED: A new propensity score-inverse probability of treatment weighting (IPTW) cohort study was conducted by using 10-year data. The study included LRT infection patients with respiratory secretions cultured positive for C. striatum simultaneously. The primary outcome was all-cause hospital mortality; the secondary outcomes included hospital stay, ICU stay and ventilation time. The safety outcomes were drug-related serum creatinine (Cr) increase and thrombocytopenia.
    UNASSIGNED: A total of 339 patients were included in the cohort, and 84 (24.78%) initiated vancomycin or linezolid therapy. In the new IPTW cohort, targeted antibiotic therapy did not improve all-cause hospital mortality (P=0.632), and the OR (95% CI) was 0.879 (0.519-1.488). Moreover, targeted antibiotic therapy was not associated with hospital stay (P=0.415), ICU stay (P=0.945) or ventilation time (P=0.885). The side effects of drug-related higher serum Cr (P=0.044) and thrombocytopenic levels (P=0.038) cannot be ignored.
    UNASSIGNED: Clinical benefits by vancomycin or linezolid targeted against LRT infection with C. striatum were limited and with drug-related side effects. A prospectively designed study is needed to further confirm the results.
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