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Eur Respir J:铜绿假单胞菌社区获得性肺炎的负担和危险因素

2018-08-10 xing.T MedSci原创

由此可见,铜绿假单胞菌CAP的多国患病率很低。该研究中确定的危险因素可以指导医疗专业人员决定CAP患者的经验性抗生素覆盖情况。

铜绿假单胞菌(Pseudomonas aeruginosa)是一种极具挑战性的细菌,因其对社区获得性肺炎(CAP)患者最常使用的抗生素具有内在耐药性。关于与铜绿假单胞菌CAP相关的全球负担和危险因素的数据十分有限。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,研究人员评估了与铜绿假单胞菌CAP相关的多国负担和特定危险因素。

研究人员在54个国家招募了3193名确诊为CAP的患者,他们在入院时接受了微生物学检测。根据铜绿假单胞菌的鉴定来计算其患病率。研究人员采用Logistic回归分析来确定抗生素敏感和抗生素耐药铜绿假单胞菌CAP的危险因素。

铜绿假单胞菌和抗生素耐药的铜绿假单胞菌CAP的患病率分别为4.2%和2.0%。由铜绿假单胞菌引起的先前感染/定植并且至少伴有三种独立相关的慢性肺病(即气管切开术、支气管扩张和/或非常严重的慢性阻塞性肺疾病)中一种的患者发生铜绿假单胞菌CAP的比率为67%。相比之下,先前没有铜绿假单胞菌感染/定植以及选择的慢性肺病患者发生铜绿假单胞菌CAP的比率为2%。

由此可见,铜绿假单胞菌CAP的多国患病率很低。该研究中确定的危险因素可以指导医疗专业人员决定CAP患者的经验性抗生素覆盖情况。

原始出处:

Marcos I. Restrepo,et al. Burden and risk factors for Pseudomonas aeruginosa community-acquired pneumonia: a multinational point prevalence study of hospitalised patients. Eur Respir J. 2018. http://erj.ersjournals.com/content/52/2/1701190

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  2. [GetPortalCommentsPageByObjectIdResponse(id=2042619, encodeId=3599204261900, content=<a href='/topic/show?id=999c88014ea' target=_blank style='color:#2F92EE;'>#获得性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88014, encryptionId=999c88014ea, topicName=获得性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Sat Oct 06 05:01:00 CST 2018, time=2018-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395791, encodeId=00bd1395e9136, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sat Aug 11 15:01:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337853, encodeId=00d933e8538c, content=好文分享,应该扩大数据范围,再进一步阐述相关性, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Sat Aug 11 07:32:53 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337625, encodeId=f17233e62587, content=对于普通患者的社区获得性肺炎。铜绿不常见~, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Fri Aug 10 06:46:27 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337606, encodeId=eb9633e60645, content=好文,值得点赞,更值得收藏!慢慢领会学习的。给点个赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Fri Aug 10 06:25:14 CST 2018, time=2018-08-10, status=1, ipAttribution=)]
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    2018-08-11 明崖

    好文分享,应该扩大数据范围,再进一步阐述相关性

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2042619, encodeId=3599204261900, content=<a href='/topic/show?id=999c88014ea' target=_blank style='color:#2F92EE;'>#获得性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88014, encryptionId=999c88014ea, topicName=获得性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Sat Oct 06 05:01:00 CST 2018, time=2018-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395791, encodeId=00bd1395e9136, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sat Aug 11 15:01:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337853, encodeId=00d933e8538c, content=好文分享,应该扩大数据范围,再进一步阐述相关性, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Sat Aug 11 07:32:53 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337625, encodeId=f17233e62587, content=对于普通患者的社区获得性肺炎。铜绿不常见~, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Fri Aug 10 06:46:27 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337606, encodeId=eb9633e60645, content=好文,值得点赞,更值得收藏!慢慢领会学习的。给点个赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Fri Aug 10 06:25:14 CST 2018, time=2018-08-10, status=1, ipAttribution=)]
    2018-08-10 太阳系小猪

    对于普通患者的社区获得性肺炎。铜绿不常见~

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2042619, encodeId=3599204261900, content=<a href='/topic/show?id=999c88014ea' target=_blank style='color:#2F92EE;'>#获得性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88014, encryptionId=999c88014ea, topicName=获得性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=docwu2019, createdTime=Sat Oct 06 05:01:00 CST 2018, time=2018-10-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1395791, encodeId=00bd1395e9136, content=<a href='/topic/show?id=7a89e4036eb' target=_blank style='color:#2F92EE;'>#社区#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74036, encryptionId=7a89e4036eb, topicName=社区)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Sat Aug 11 15:01:00 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337853, encodeId=00d933e8538c, content=好文分享,应该扩大数据范围,再进一步阐述相关性, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=73441710184, createdName=明崖, createdTime=Sat Aug 11 07:32:53 CST 2018, time=2018-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337625, encodeId=f17233e62587, content=对于普通患者的社区获得性肺炎。铜绿不常见~, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Fri Aug 10 06:46:27 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337606, encodeId=eb9633e60645, content=好文,值得点赞,更值得收藏!慢慢领会学习的。给点个赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRuUXgacXpPeW0x8Z3Qr9c3I2kTic4ZIpR29iaftYgkjRcbv982icYMtqANBPYBgPnOia6mVtX76qMXuc/0, createdBy=d85d1636106, createdName=lietome2, createdTime=Fri Aug 10 06:25:14 CST 2018, time=2018-08-10, status=1, ipAttribution=)]
    2018-08-10 lietome2

    好文,值得点赞,更值得收藏!慢慢领会学习的。给点个赞!

    0

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铜绿假单胞菌是一种革兰氏阴性机会致病菌,可导致急性和慢性感染。感染宿主后,铜绿假单胞菌可改变基因表达以适应宿主环境并避免被宿主免疫系统清除。脯氨酸利用A(PutA)是将脯氨酸转化为谷氨酸的双功能酶。本研究中,研究人员发现PutA是小鼠急性肺炎模型中铜绿假单胞菌发挥毒力所必需的。 研究结果显示,与野生型菌株相比,putA突变体对氧化应激更敏感。AraC/XylS家族蛋白成员——PruR直接与p

Eur Respir J:铜绿假单胞菌感染对支气管扩张症长期临床结局的独立影响!

由此可见,铜绿假单胞菌被发现与病情恶化、入院和生活质量较差有关。铜绿假单胞菌感染患者的死亡率增加,尤其是在频繁恶化的情况下。

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