Baidu
map

Thorax:宿主因素更能预测肺炎球菌肺炎死亡风险

2013-03-01 Jane译 医学论坛网

  瑞典斯德哥尔摩卡罗琳医学院肿瘤与细胞生物微生物科的一项研究表明,宿主因素作为菌血症性肺炎球菌肺炎患者的死亡决定因子似乎比特定血清型更好。已找到一些促进死亡的宿主因素,这对于诊断很重要,并且能指导(制定)定向预防策略。该论文于2013年2月26日在线发表在《thorax》杂志上。   研究者开展一项针对瑞典2007-2009年1580例社区获得性菌血症性肺炎球菌肺炎成人患者的队列研究。目的是评

  瑞典斯德哥尔摩卡罗琳医学院肿瘤与细胞生物微生物科的一项研究表明,宿主因素作为菌血症性肺炎球菌肺炎患者的死亡决定因子似乎比特定血清型更好。已找到一些促进死亡的宿主因素,这对于诊断很重要,并且能指导(制定)定向预防策略。该论文于2013年2月26日在线发表在《thorax》杂志上。

  研究者开展一项针对瑞典2007-2009年1580例社区获得性菌血症性肺炎球菌肺炎成人患者的队列研究。目的是评估宿主因素、细菌因素和抗生素治疗对促进菌血症性肺炎球菌肺炎死亡率的相对作用。收集病人记录中宿主因素和初始抗生素治疗的数据。抗生素抗药性和血清型用于确定细菌菌株。Logistic回归分析用于评估30天死亡风险因素。

  结果显示,吸烟、酗酒、实体肿瘤、肝病和肾病归因于死亡的分别占14.9%、13.1%、13.1%、8.0%和7.4%。年龄是最有力的预测因子,死亡率呈指数增加,从1.3%(年龄<45岁)增加到26.1%(年龄≥85岁)。宿主因素在与血清型和死亡率间的关联上有相当的混杂因素。ICU患者的年龄增加、肝病和血清型均与死亡率相关。β-内酰胺抗生素和大环内酯/喹诺酮联合治疗与降低ICU患者死亡率相关,尽管不排除混杂因素。

肺炎相关的拓展阅读:


Contribution of host, bacterial factors and antibiotic treatment to mortality in adult patients with bacteraemic pneumococcal pneumonia

Rationale 
Host and bacterial factors as well as different treatment regimens are likely to influence the outcome in patients with bacteraemic pneumococcal pneumonia.
Objectives 
To estimate the relative contribution of host factors as well as bacterial factors and antibiotic treatment to mortality in bacteraemic pneumococcal pneumonia.
Methods 
A cohort study of 1580 adult patients with community-acquired bacteraemic pneumococcal pneumonia was conducted between 2007 and 2009 in Sweden. Data on host factors and initial antibiotic treatment were collected from patient records. Antibiotic resistance and serotype were determined for bacterial isolates. Logistic regression analyses were performed to assess risk factors for 30-day mortality.
Results 
Smoking, alcohol abuse, solid tumour, liver disease and renal disease attributed to 14.9%, 13.1%, 13.1%, 8.0% and 7.4% of the mortality, respectively. Age was the strongest predictor, and mortality increased exponentially from 1.3% in patients <45 years of age to 26.1% in patients aged ≥85 years. There was considerable confounding by host factors on the association between serotype and mortality. Increasing age, liver disease and serotype were associated with mortality in patients admitted to the ICU. Combined treatment with β-lactam antibiotics and macrolide/quinolone was associated with reduced mortality in patients in the ICU, although confounding could not be ruled out.
Conclusions 
Host factors appear to be more important than the specific serotype as determinants of mortality in patients with bacteraemic pneumococcal pneumonia. Several host factors were identified that contribute to mortality, which is important for prognosis and to guide targeted prevention strategies.

    

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (3)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1255433, encodeId=57e41255433e1, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1404622, encodeId=989114046229b, content=<a href='/topic/show?id=1a4f4649925' target=_blank style='color:#2F92EE;'>#宿主#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46499, encryptionId=1a4f4649925, topicName=宿主)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485630, encodeId=419e14856302d, content=<a href='/topic/show?id=e1ec821e823' target=_blank style='color:#2F92EE;'>#肺炎球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82178, encryptionId=e1ec821e823, topicName=肺炎球菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e328034144, createdName=ms24272190615788285182, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1255433, encodeId=57e41255433e1, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1404622, encodeId=989114046229b, content=<a href='/topic/show?id=1a4f4649925' target=_blank style='color:#2F92EE;'>#宿主#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46499, encryptionId=1a4f4649925, topicName=宿主)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485630, encodeId=419e14856302d, content=<a href='/topic/show?id=e1ec821e823' target=_blank style='color:#2F92EE;'>#肺炎球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82178, encryptionId=e1ec821e823, topicName=肺炎球菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e328034144, createdName=ms24272190615788285182, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1255433, encodeId=57e41255433e1, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1404622, encodeId=989114046229b, content=<a href='/topic/show?id=1a4f4649925' target=_blank style='color:#2F92EE;'>#宿主#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46499, encryptionId=1a4f4649925, topicName=宿主)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1485630, encodeId=419e14856302d, content=<a href='/topic/show?id=e1ec821e823' target=_blank style='color:#2F92EE;'>#肺炎球菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82178, encryptionId=e1ec821e823, topicName=肺炎球菌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e328034144, createdName=ms24272190615788285182, createdTime=Sun Mar 03 01:06:00 CST 2013, time=2013-03-03, status=1, ipAttribution=)]
Baidu
map
Baidu
map
Baidu
map