Mortality and hospital stay associated with resistant Staphylococcus aureus and Escherichia coli bacteremia: estimating the burden of antibiotic resistance in Europe.
与耐药金黄色葡萄球菌和大肠杆菌菌血症相关的死亡率和住院时间: 估计欧洲抗生素耐药性的负担。

摘要

The relative importance of human diseases is conventionally assessed by cause-specific mortality, morbidity, and economic impact. Current estimates for infections caused by antibiotic-resistant bacteria are not sufficiently supported by quantitative empirical data. This study determined the excess number of deaths, bed-days, and hospital costs associated with blood stream infections (BSIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) and third-generation cephalosporin-resistant Escherichia coli (G3CREC) in 31 countries that participated in the European Antimicrobial Resistance Surveillance System (EARSS).The number of BSIs caused by MRSA and G3CREC was extrapolated from EARSS prevalence data and national health care statistics. Prospective cohort studies, carried out in hospitals participating in EARSS in 2007, provided the parameters for estimating the excess 30-d mortality and hospital stay associated with BSIs caused by either MRSA or G3CREC. Hospital expenditure was derived from a publicly available cost model. Trends established by EARSS were used to determine the trajectories for MRSA and G3CREC prevalence until 2015. In 2007, 27,711 episodes of MRSA BSIs were associated with 5,503 excess deaths and 255,683 excess hospital days in the participating countries, whereas 15,183 episodes of G3CREC BSIs were associated with 2,712 excess deaths and 120,065 extra hospital days. The total costs attributable to excess hospital stays for MRSA and G3CREC BSIs were 44.0 and 18.1 million Euros (63.1 and 29.7 million international dollars), respectively. Based on prevailing trends, the number of BSIs caused by G3CREC is likely to rapidly increase, outnumbering the number of MRSA BSIs in the near future.Excess mortality associated with BSIs caused by MRSA and G3CREC is significant, and the prolongation of hospital stay imposes a considerable burden on health care systems. A foreseeable shift in the burden of antibiotic resistance from Gram-positive to Gram-negative infections will exacerbate this situation and is reason for concern.

译文

人类疾病的相对重要性通常通过特定原因的死亡率、发病率和经济影响来评估。目前对抗生素抗性细菌引起的感染的估计没有得到定量经验数据的充分支持。这项研究确定了由耐甲氧西林金黄色葡萄球菌 (MRSA) 引起的与血流感染 (BSIs) 相关的死亡人数、卧床天数和住院费用 31 个国家的第三代头孢菌素耐药大肠杆菌 (G3CREC) 参与了欧洲抗菌药物耐药性监测系统(EARSS)。由 MRSA 和 G3CREC 引起的 BSIs 数量是根据 EARSS 患病率数据和国家卫生保健统计数据推断的。2007年在参与 EARSS 的医院进行的前瞻性队列研究提供了估计 MRSA 或 G3CREC 引起的 BSIs 相关的 30 天死亡率和住院时间的参数。医院支出来源于公开可用的成本模型。由 EARSS 建立的趋势被用来确定 MRSA 和 G3CREC 的流行轨迹,直到 2015年。2007,在参与国,27,711 次耐甲氧西林金黄色葡萄球菌 BSIs 的发作与 5,503 的超额死亡和 255,683 的超额住院日有关。而 G3CREC BSIs 的 15,183 次发作与 2,712 的超额死亡和 120,065 的额外住院日有关。MRSA 和 G3CREC BSIs 的额外住院费用分别为 44.0 和 1810万欧元 (63.1 和 2970万国际美元)。根据流行趋势,由 G3CREC 引起的 BSIs 数量可能会迅速增加,在不久的将来超过 MRSA BSIs 的数量。 MRSA 和 G3CREC 引起的 BSIs 相关的超额死亡率是显著的,住院时间的延长给医疗保健系统带来了相当大的负担。抗生素耐药性负担从革兰氏阳性到革兰氏阴性感染的可预见转变将加剧这种情况,这是令人担忧的原因。

Bacteremia

儿科 血液 疾病
概述  :  

菌血症是一个实验室诊断名称,指血培养阳性,但无明显临床表现。迄今为止,尚无有效的检出菌血症病人的方法。困难之一是菌血症的严重程度变异极大。部分病人血中仅有少量细菌,且很容易被清除(如牙科手术后);另一部分有中等量的细菌,可有或无迁徙性感染灶;还有一部分有大量细菌,可危及生命。部分菌血症并发于局灶性感染,其它则为原发性。另一个困难是严重菌血症常见于6-24个月的小儿,难以取得完整的客观病史,其它发热性疾病也常见。辅助检查除血培养外,其它可能有意义的辅助检查包括:取血沉棕黄层、皮肤脓疱或出血点

bacteremia 英 /bæktə'ri:miə/  美 /,bæktə'rimɪə/

释    义   n. [内科] 菌血症

例    句   Factors such as a transient bacteremia from any of several sources may lead to wound infection.来自几种来源中任何一种的暂时的菌血症的因素可导致伤口感染。

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