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Epidemiology of methicillin-resistant Staphylococcus aureus infection and empirical antibiotic therapy for MRSA infection： multicenter investigation

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Chinese Medical Journal 2013年第19期126卷 3745-3749页

作者： DENG Li-jing WU Xiao-dong KANG Yan XU Yuan ZHOU Jian-xin WANG Di-fen CHEN De-chang Department of Critical Care Medicine West China Hospital of Sichuan University Chengdu Sichuan 610041 China Department of Critical Care Medicine Beijing Tongren Hospital Beijing 100730 China Department of Critical Care Medicine Beijing Tiantan Hospital Beijing 10050 China Department of Critical Care Medicine Affiliated Hospital of Guiyang Medical College Guiyang Guizhou 550004 China Department of Critical Care Medicine Shanghai Changzhen Hospital Shanghai 200003 China

Background The epidemiology of methicillin-resistant Staphylococcus aureus （MRSA） maybe changed by strict infection control measures,and the impact of empirical antibiotic therapy on the outcomes of MRSA infection was not *** aimed to investigate the present epidemiological status of MRSA infection and empirical antibiotic therapy for MRSA infection in university teaching hospitals in China's *** The present study was a multicenter prospective observational study conducted in five university teaching *** who were consecutively admitted to the intensive care unit and signed a consent form from March 3,2011 to May 31,2011 were *** with age 〈18 years or with a length of hospital stay 〈48 hours were excluded from this *** following variables were collected or recorded：demographic data,general status,APACHE Ⅱ score of the patient at the time of admission,infections,and the use of antibiotics during a *** outcomes and prognostic indicators included length of hospital stay and 28-day and 90-day *** differences between the patients with appropriate empirical therapy and patients with inappropriate therapy were analyzed to detect the influences of antibiotic therapy on the prognosis of MRSA *** A total of 682 cases were *** （66.2%） of 88 MRSA cases were treated with effective antibiotics for MRSA infection; only 20% received appropriate empirical antibiotic *** empirical therapy group compared with the target therapy group had a shorter length of stay,but there were no significant differences in mortality *** were no significant differences in the length of hospital stay,length of stay,and 28-day and 90-day mortality between MRSA-infected patients who received or not received effective *** hundred and eighteen cases received sensitive antibiotics for *** The MRSA infection rates are at relatively low levels in university teaching hospit

关键词： methicillin-resistant Staphylococcus aureus empirical antibiotic therapy epidemiology mortality

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Retrospective study of the incidence, risk factors, treatment outcomes of bacterial infections at uncommon sites in cirrhotic patients

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World Journal of Hepatology 2024年第3期16卷 418-427页

作者： Sophie Schneitler Christina Schneider Markus Casper Frank Lammert Marcin Krawczyk Sören L Becker Matthias Christian Reichert Institute of Medical Microbiology and Hygiene Saarland UniversityHomburg 66421Germany Department of Medicine II Saarland University Medical CenterHomburg 66421Germany Health Sciences Hannover Medical SchoolHannover 30625Germany Laboratory of Metabolic Liver Diseases Department of GeneralTransplant and Liver SurgeryCentre for Preclinical ResearchMedical University of WarsawWarsaw 02-097Poland

BACKGROUND Bacterial infections(BI)negatively affect the natural course of *** most frequent BI are urinary tract infections(UTI),pneumonia,and spontaneousbacterial peritonitis(SBP).AIM To assess the relevance of bacterial infections beyond the commonly recognized types in patients with cirrhosis and to investigate their relationship with other clinical *** We retrospectively analyzed patients with cirrhosis and BI treated between 2015 and 2018 at our tertiary care *** were classified as typical and atypical,and clinical as well as laboratory parameters were compared between the two *** In a cohort of 488 patients with cirrhosis,we identified 225 typical BI(95 UTI,73 SBP,72 pulmonary infections)and 74 atypical BIs,predominantly cholangitis and soft tissue infections(21 each),followed by intra-abdominal BIs(n=9),cholecystitis(n=6),head/throat BIs(n=6),osteoarticular BIs(n=5),and endocarditis(n=3).We did not observe differences concerning age,sex,or etiology of cirrhosis in patients with typical vs atypical *** BIs were more common in patients with more advanced cirrhosis,as evidenced by Model of End Stage Liver Disease(15.1±7.4 vs 12.9±5.1;P=0.005)and Child-Pugh scores(8.6±2.5 vs 8.0±2;P=0.05).CONCLUSION Atypical BIs in cirrhosis patients exhibit a distinct spectrum and are associated with more advanced stages of the ***,the work-up of cirrhosis patients with suspected BI requires detailed work-up to elucidate whether typical BI can be identified.

关键词： Bacterial infection empirical antibiotic therapy End-stage liver disease Escherichia coli Multi-resistant pathogens

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