重症监护病房多药耐药杨梅感染的临床和微生物学特征及抗菌药物敏感性模式：一项回顾性研究

摘要(中文译文)

重症监护病房患者面临由多重耐药（MDR）病原体引起感染的风险，包括机会性致病菌 spp.。本研究旨在描述MDR spp.感染的临床和微生物学特征，并报告抗菌药物敏感性模式及临床实践中采用的治疗方案。在这项回顾性单中心研究中，纳入了2017年至2023年间在土耳其一家三级医疗中心住院且符合真性感染标准的70例患者，尽管从509份临床标本中分离出了 spp.。对人口学、临床和实验室数据进行了描述性分析。使用VITEK 2 GN系统对来自血液、尿液、伤口拭子和侵入性操作的标本进行细菌鉴定和抗菌药物敏感性试验。分离株对大多数所测试的常规抗生素表现出高水平耐药。替加环素显示出最高的体外敏感性率，95.2%的分离株被归类为敏感。替加环素也是临床管理中最常用的抗菌药物，平均治疗时间为10.3天。患者平均年龄为72.7岁，88.5%的患者接受了替加环素治疗。大多数感染涉及尿路，而一名患者发展为侵袭性疾病，同时伴有菌血症和肺炎。MDR spp.感染在重症监护环境中仍然罕见但具有临床相关性。替加环素所观察到的高体外敏感性及其在治疗中的频繁使用凸显了其在这些感染管理中的潜在作用。然而，需要进一步开展比较设计的研究，以更好地确定最佳治疗策略。

Abstract

Patients in intensive care units are at risk of infections caused by multidrug-resistant (MDR) pathogens, including the opportunistic bacterium spp. This study aimed to describe the clinical and microbiological characteristics of MDR spp. infections and to report antimicrobial susceptibility patterns and treatment approaches used in clinical practice. In this retrospective single-center study, 70 patients hospitalized in a tertiary care center in Türkiye between 2017 and 2023 who met criteria for true infection were included, although spp. was isolated from 509 clinical specimens. Demographic, clinical, and laboratory data were analyzed descriptively. Bacterial identification and antimicrobial susceptibility testing were performed using the VITEK 2 GN system on specimens obtained from blood, urine, wound swabs, and invasive procedures. The isolates demonstrated high levels of resistance to most conventional antibiotics tested. Tigecycline showed the highest in vitro susceptibility rate, with 95.2% of isolates classified as susceptible. Tigecycline was also the most frequently used antimicrobial agent in clinical management, with a mean treatment duration of 10.3 days. The mean patient age was 72.7 years, and tigecycline treatment was administered to 88.5% of the patients. Most infections involved the urinary tract, while one patient developed invasive disease with concurrent bacteremia and pneumonia. MDR spp. infections remain rare but clinically relevant in intensive care settings. The high in vitro susceptibility observed for tigecycline and its frequent use in treatment highlight its potential role in the management of these infections. However, further studies with comparative designs are needed to better define optimal therapeutic strategies.

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