Bacteria Infection In Patients Research Articles

Risk factors of multidrug-resistant bacteria infection in patients with ventilator-associated pneumonia: A systematic review and meta-analysis

BackgroundMultidrug-resistant (MDR) bacteria-induced VAP often has high lethality. We present this systematic review and meta-analysis to assess the risk factors for MDR bacterial infection in patients with VAP. MethodsPubMed, EMBASE, Web of Science, and Cochrane Library were searched for studies regarding MDR bacterial infection in VAP patients, from Jan 1996 to Aug 2022. Study selection, data extraction, and quality assessment of included studies were conducted by two reviewers independently, and potential risk factors for MDR bacterial infection were identified. ResultsMeta-analysis showed that the score of the Acute Physiology and Chronic Health Evaluation II (APACHE-II) [OR = 1.009, 95% (CI 0.732, 1.287)], Simplified Acute Physiology Score II (SAPS-II) [OR = 2.805, 95%CI (0.854, 4.755)], length of hospital-stay before VAP onset (days) [OR = 2.639, 95%CI (0.387, 4.892)], in-ICU duration [OR = 3.958, 95%CI (0.894, 7.021)], Charlson index [OR = 1.000, 95%CI (0.889, 1.111)], overall hospital-stay [OR = 20.742, 95%CI (18.894, 22.591)], Medication of Quinolones [OR = 2.017, 95%CI (1.339, 3.038)], medication of carbapenems [OR = 3.527, 95%CI (2.476, 5.024)], combination of more than 2 prior antibiotics [OR = 3.181, 95%CI (2.102, 4.812)], and prior use of antibiotics [OR 2.971, 95%CI (2.001, 4.412)] were independent risk factors of MDR bacterial infection in VAP patients. Diabetes and mechanical ventilation duration before VAP onset showed no association with risk for MDR bacterial infection. ConclusionsThis study has identified 10 risk factors associated with MDR bacterial infection in VAP patients. Identification of these factors would be able to facilitate the treatment and prevention of MDR bacterial infection in clinical practice.

Risk Factors of Urinary Pathogenic Bacteria Infection after Benign Prostatic Hyperplasia Surgery and Curative Effect Analysis of Shuangdong Capsule Intervention.

Benign prostatic hyperplasia (BPH) is a common and frequently occurring disease in clinics, with the main manifestations including frequent micturition, urinary incontinence, dysuria, and endless urination. Transurethral resection of the prostate (TURP) is the main treatment for BPH, but some patients are prone to urinary tract infection after surgery, which affects the prognosis. Therefore, it is of great significance to study the pathogenic characteristics and risk factors of postoperative urinary-derived pathogenic bacteria infection in patients with BPH for the prevention and treatment of postoperative infection. In addition, the treatment of patients with this disease is also the focus of clinical attention. Long-term massive application of antibiotics can induce drug-resistant mutations of bacteria, so it is urgent to find an efficient and safe therapeutic scheme in clinics. However, traditional Chinese medicine (TCM) has a long history of treating urinary tract infections. Therefore, Shuangdong capsule, a traditional Chinese medicine preparation, was selected for the combined treatment in this study. The results showed that age, concomitant diabetes mellitus, and preoperative prophylactic application of antibiotics were the independent risk factors for postoperative urine-derived pathogenic infection in BPH patients. Clinical intervention for BPH patients with concomitant risk factors should be emphasized in clinical practice. The combined use of Shuangdong capsule and conventional western medicine can improve the clinical symptoms and inflammatory reactions of postoperative urine-derived pathogenic infection in BPH patients. Due to its exact curative effect and high safety, it is worthy of promotion. The clinical study registration number is M2022019.

Postoperative drug-resistant bacteria infection in patients with acute Stanford type A aortic dissection under two-fluid numerical simulation model

ObjectiveThis study was to investigate the characteristics and related factors of postoperative drug-resistant bacteria infection (DRBI) in patients with acute Stanford A aortic dissection (AD) (AAAD) based on a two-fluid numerical simulation model (TFNS model). Methods50 patients with AAAD admitted to our hospital from July 2018 to October 2020 were selected as the research objects. The patients were rolled into an infection group and a non-infection group according to whether DRBI occurred after surgery. There were 21 patients in the infected group and 29 patients in the non-infected group. The clinical data of the patients were collected, including preoperative, intraoperative, and postoperative conditions. A TFNS model was constructed. The construction of vascular physical model could be completed by the construction of fluid area and solid area. The blood flows through the fluid area and the blood vessel wall was located in the solid area. The model was adopted to study the characteristics of DRBI. The data of the patients were analyzed to explore the relationship of the multi-DRBI to intraoperative blood loss, postoperative complications, intensive care unit (ICU) stay time, invasive procedures, and use of antibiotics. In addition, the multi-factor postoperative multi-DRBI was performed with the regression analysis. ResultsThere was no significant difference between the infected group and the non-infected group in antibiotics used such as cephalosporin, penicillin, glycopeptide, and quinolones (P > 0.05). The time spent on antibiotics was greatly lower in the infected group than in the non-infected group (P < 0.05). The ICU stay time in the infected group was 17.78 ± 11.55, and that in the non-infected group was 6.67 ± 4.36, without notable difference between the two groups (P < 0.05). In addition, there was no significant difference between the two groups in the time to transfer to the ICU, while there was one case infected with Staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacter cloacae. The excessive plasma loss (odds ratio (OR) = 3.823, 95% confidential interval (CI) = 1.643–8.897), renal insufficiency (OR = 1.855, 95% CI = 1.076–3.199), ICU stay time (OR = 5.089, 95% CI = 1.507–17.187), indwelling time of nasal feeding tube (NFT) (OR = 3.225, 95% CI = 1.332–7.807), assisted ventilation (OR = 3.077, 95% CI = 1.640–5.773), tracheal intubation (OR = 5.078, 95% CI = 1.415–18.227), tracheotomy (OR = 0.073, 95% CI = 0.013–0.382), continuous renal replacement (CRR) therapy (OR = 0.111, 95% CI = 0.023–0.476), use time of antibiotics (OR = 1.089, 95% CI = 1.038–1.143) were independent risk factors for postoperative multi-DRBI. Conclusionpostoperative multi-DRBI was characterized by Acinetobacter baumannii infection with the largest proportion, followed by Klebsiella pneumoniae; excessive plasma loss, renal insufficiency, ICU stay time, indwelling time of NFT, assisted ventilation, tracheal intubation, tracheotomy, CRR therapy, and use time of antibiotics were all independent risk factors of postoperative multi-DRBI. In the postoperative care of AAAD patients, the inducing factors had to be informed to the patient, and relative measures should be taken to prevention and treatment, which was conductive to reducing the incidence of infection and promote the recovery of AAAD.

Efficacy observation of tigecycline in the treatment of 107 patients with infection due to granulocytopenia

目的观察替加环素治疗粒细胞缺乏合并感染血液病患者的疗效和安全性。方法回顾性分析107例使用替加环素治疗粒细胞缺乏并感染血液病患者的临床资料，替加环素初始剂量100 mg，维持剂量50 mg，每12 h 1次，30~60 min静脉滴注完毕，患者体温正常5~7 d后开始予抗菌药物降阶梯治疗或停药。结果107例患者住院期间共分离出病原菌104株，其中多重药耐菌株（MDR）60株，泛耐药菌株（XDR）2株。全部107例患者中，30例单用替加环素，21例初始单用替加环素后联合其他抗菌药物，56例初始即替加环素联合其他抗菌药物，3组患者治疗有效率分别为63.3%、61.9％及62.5%，差异无统计学意义（P=0.994），替加环素治疗总有效率为62.6%。39例分离出MDR的患者中，22例体温得到控制，8例体温未得到控制，9例死亡，临床有效率为56.4%。替加环素起效的中位时间为3 d。不良反应以恶心（11.2%）、呕吐（8.4%）为主，均可以耐受。结论替加环素治疗粒细胞缺乏血液病患者耐药菌感染具有较好的疗效，引发的不良反应少，安全可耐受。

Distribution and antibiotics resistance related to nosocomial pathogenic bacteria infection in patients after cardiac surgery

To investigate the clinical distribution and antibiotics resistance of nosocomial infection caused pathogenic bacteria in patients after cardiac surgery. Clinical data from 612 patients after cardiac surgery under microbiologically documented nosocomial infection was retrospectively analyzed from January 2007 to December 2012. Identification on related bacterial was performed in an automatic ATB Expression system while antimicrobial susceptibility was tested by Kirby-Bauer method. were analyzed by WHONET5.4. There were 697 strains of clinical pathogenic bacilli isolates identified and 421 (60.4%) of them were isolated from sputum while 185 (26.5%) were from blood. Acinetobacter spp. (124 strains, 17.8%), Pseudomonas aeruginosa (85 strains, 12.2%) and Klebsiella pneumoniae (50 strains, 7.2%) were the predominant Gram-negative bacilli while S. epidermidis (75 strains, 10.8%) was the predominant Gram-positive cocci. The predominant eumycete was Candida albicans (43 strains, 6.2%). from the susceptibility test showed that carbapenems, cefoperazone/sulbactam and piperacillin/tazobactam were the most active antibiotics. The detection of meticillin-resistant Staphylococcus (MRS) were 82.9% in S aureus and 95.9% in coagulase negative Staphylococcus. There was no Staphylococcus strains resistant to vancomycin found. Non-fermenting Gram-negative bacilli and Staphylococcus appeared the important pathogens in patients after cardiac surgery. Drug resistance to antibiotics was quite common. Prevention on nosocomial infection and rational use of antibiotics remained very important in reducing the amount of drug resistant strains.

The distribution and pathogen of bacteria infection in patients after liver transplantation

To find out the epidemiology of bacteria infection after orthotopic liver transplantation (OLT). Postoperative bacteria infection of 451 OLT cases were retrospectively analyzed. Bacteria infection were detected in 239 OLT cases, and the infection rate was 52.9%. Sum up to 304 bacilli lines were separated from all above cases. Among them, the detectable Gram-positive bacilli (G(+)) accounted for 59.9% (182/304), while Gram-negative bacilli (G(-)) accounted for 40.2% (122/304). The impressionable organ were respiratory tract and bile duct, which occupying 81.5% (248/304) and 15.1% (46/304) among all infective cases respectively. The main infected strain were G(+) bacteria in respiratory tract, account for 65.3%; while G(-) bacteria were mainly in bile duct, account for 60.9%. There was significant difference between each other (P = 0.018). The bacteria infection rate was high after OLT, and the main infected strain was the G(+) bacteria. Most fo them were the opportunistic pathogenic bacteria and the antibiotic multi-resistant bacteria. The bacteria category was significantly related to the infected tissue, according to which we could adopt corresponding antibacterial approach.