■入住重症监护病房(ICU)的患者,革兰氏阴性菌(GNB)感染由于其对发病率的贡献而构成重大挑战。死亡率,和医疗费用。在SARS-CoV-2大流行期间,意大利见证了医疗保健相关感染(HAIs)的上升,GNB参与了相当大比例的病例。令人担心的是,耐碳青霉烯的GNBs(CR-GNBs)在全球范围内有所增加,带来治疗挑战。
■回顾性多中心研究分析了2013年至2022年意大利ICU收治的299,000多名患者的数据。
■研究显示,每名患者平均有1.5例感染,HAIs在大流行期间达到顶峰。呼吸机相关性肺炎(VAP)是最常见的HAI,克雷伯菌属。铜绿假单胞菌占主导地位。令人震惊的是,CR-GNBs占感染的很大比例,特别是在VAP中,血流感染,和腹腔内感染。
■我们的发现强调了加强感染控制措施的迫切需要,特别是在ICU环境中,减轻CR-GNBs患病率上升及其对患者预后的影响。该研究提供了对意大利ICUHAIs流行病学的宝贵见解,并强调了CR-GNB带来的挑战,特别是在SARS-CoV-2大流行的背景下,这加剧了这一问题,并可能成为管理未来病毒大流行的一个重要例子。
UNASSIGNED: In patients admitted to intensive care units (ICUs), Gram-negative bacteria (GNB) infections pose significant challenges due to their contribution to morbidity, mortality, and healthcare costs. During the SARS-CoV-2 pandemic, Italy witnessed a rise in healthcare-associated infections (HAIs), with GNBs involved in a substantial proportion of cases. Concerningly, carbapenem-resistant GNBs (CR-GNBs) have increased worldwide, posing therapeutic challenges.
UNASSIGNED: Retrospective multicentre study analysing data from over 299,000 patients admitted to Italian ICUs from 2013 to 2022.
UNASSIGNED: The study revealed an average of 1.5 infections per patient, with HAIs peaking during the pandemic years. Ventilator associated pneumonia (VAP) emerged as the most common HAI, with Klebsiella spp. and Pseudomonas aeruginosa predominating. Alarmingly, CR-GNBs accounted for a significant proportion of infections, particularly in VAP, bloodstream infections, and intra-abdominal infections.
UNASSIGNED: Our findings underscore the pressing need for enhanced infection control measures, particularly in the ICU setting, to mitigate the rising prevalence of CR-GNBs and their impact on patient outcomes. The study provides valuable insights into the epidemiology of HAIs in Italian ICUs and highlights the challenges posed by CR-GNBs, especially in the context of the SARS-CoV-2 pandemic, which exacerbated the issue and may serve as a crucial example for the management of future viral pandemics.