嗜麦芽窄食单胞菌感染死亡率有关的风险因素：系统综述

David

Journal of Hospital Infection
Volume 70, Issue 2, October 2008, Pages 101-108

Review
Risk factors associated with mortality of infections caused by Stenotrophomonas maltophilia: a systematic review
嗜麦芽窄食单胞菌感染死亡率有关的风险因素：系统综述
J.I. Garcia Paeza and S.F. Costa, a,

aDepartment of Infectious Diseases, University of São Paulo Medical School, São Paulo, Brazil
Available online 14 July 2008.

Summary
The objective of this review was to assess the quality of available literature regarding risk factors associated with mortality of infections caused by S. maltophilia. PubMed and OVID were searched from March 1985 to March 2008, and eligible studies were considered to be those that related S. maltophilia infection with risk factors associated with mortality; described the characteristics of patients in detail; and provided data regarding the outcome and mortality. Thirty-eight studies were found referring to S. maltophilia (four with multivariate analysis and 10 with univariate analysis). This review has several limitations, mainly due to the heterogeneity of patients, lack of appropriate statistical analysis and lack of definition of nosocomial and community infection studies. Data reviewed suggest that infections caused by S. maltophilia have high mortality and that the risk factors associated with mortality are related to the initial clinical condition and patient type. Underlying haematological disease in cancer patients and admission to the intensive care unit are independent risk factors associated with mortality. Shock, thrombocytopenia and Acute Physiological Assessment and Chronic Health Evaluation (APACHE) score >15 are independent risk factors associated with outcome in patients with bloodstream infection and pneumonia. Organ dysfunction is the only independent risk factor associated with death from infection caused by sulfamethoxazole-resistant S. maltophilia. The impact of adequate antimicrobial therapy and removal of central venous catheter on mortality require further clinical studies.

Keywords: Stenotrophomonas maltophilia; Bloodstream infection; Pneumonia; Risk factor; Mortality

楚楚

癌症病人潜在的血液病和入住ICU是与死亡率相关的独立的危险因素.休克，血小板减少症和APACHE评分大于15是血流感染与肺炎相关的独立的危险因素.器官机能障碍是唯一与嗜麦芽窄食单胞菌导致感染死亡相关的独立的危险因素. 恰当的抗生素治疗和移去中心静脉导管对死亡率的影响需要进一步的临床研究。

希望高手指点:$

拙凌

size=3]有一点点错误，纠正如下：
“对于癌症病人来说，潜在的血液病和入住ICU是与死亡率相关的独立的危险因素。
休克、血小板减少症和APACHE评分大于15是血流感染和肺炎发生相关的独立的危险因素。
器官机能障碍是唯一与耐复方新诺明的嗜麦芽窄食单胞菌导致感染死亡相关的独立的危险因素。
恰当的抗生素治疗和移去中心静脉导管对死亡率的影响需要进一步的临床研究。”

拙凌

篇综述主要是分析了嗜麦芽窄食单胞菌感染死亡率有关的风险因素，作者筛选出14篇文献，有4篇关于多重因素分析，有10篇关于单一因素分析。这份综述受到一些限制，主要是由于病人的不均一，缺乏恰当的统计学分析，医院感染和社区感染定义的不统一等等因素。数据表明感染嗜麦芽窄食单胞菌会导致高死亡率，并且死亡相关危险因素与早期临床症状和病人类型有关。具体如上总结。