Đặc điểm trực khuẩn Gram âm kháng thuốc khó điều trị gây nhiễm khuẩn huyết tại Bệnh viện Nhi Đồng 2=Characteristics of drug-resistant gram-negative bacteria that are difficult to treat, causing sepsis at Children's Hospital 2

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Tác giả: Thế Trung Bùi, Minh Nga Cao, Văn Khoa Dương, Thanh Phong Huỳnh, Thị Thanh Thùy Lê, Thị Thùy Trang Nguyễn, Văn Lượm Phan, Thị Phương Trang Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.282-288

Bộ sưu tập: Metadata

ID: 246343

Thêm vào giỏ

Difficult-to-treat resistance in Gram-negative bacteria is identified when the bacteria exhibit resistance to all first-line antibiotics, particularly those belonging to the β-lactam and fluoroquinolone groups. This new definition focuses on the impact of drug resistance on treatment decisions and clinical outcomes. This study aims to determine the prevalence of drug-resistant Gram-negative bacilli that are difficult to treat and cause sepsis, as well as the relationship between these bacteria and some factors. Methods: A descriptive cross-sectional study was collected at Children's Hospital 2 between July 1, 2021, and June 30, 2023. Results:. The proportion of DTR Gram-negative bacilli was 50.5% (190/376). There was no link between leukopenia and the cause of bacteremia or DTR bacteria. There were statistically significant variations among treatment departments, ventilator use, surgery, hospital-acquired sepsis, and DTR bacterial sepsis. Conclusions: Sepsis caused by DTR bacteria will increase mortality rates and prolong hospital stays. Patients with DTR bacterial sepsis had a 1.76 times higher risk of death than patients with non-DTR bacterial sepsis, with a 95% KTC of 1.26 to 2.46.Trực khuẩn Gram âm kháng thuốc khó điều trị được xác định khi vi khuẩn kháng tất cả các kháng sinh đầu tay, cụ thể là các kháng sinh thuộc nhóm β-lactam và fluoroquinolone. Định nghĩa mới này tập trung vào ảnh hưởng của kháng thuốc đối với các quyết định điều trị và kết quả lâm sàng. Nghiên cứu này nhằm xác định tỷ lệ trực khuẩn Gram âm kháng thuốc khó điều trị gây nhiễm khuẩn huyết và mối liên quan giữa vi khuẩn này với một số yếu tố. Phương pháp nghiên cứu: Nghiên cứu cắt ngang mô tả, được thực hiện tại Bệnh viện Nhi Đồng 2 trong khoảng thời gian từ 01/07/2021 đến ngày 30/06/2023. Kết quả: Tỷ lệ trực khuẩn Gram âm DTR chiếm 50,5% (190/376). Không có mối liên quan giữa giảm bạch hạt và nguồn gây nhiễm khuẩn huyết với nhiễm khuẩn huyết do vi khuẩn DTR. Có sự khác biệt có ý nghĩa thống kê giữa khoa điều trị, sử dụng máy thở, phẫu thuật, nhiễm khuẩn huyết bệnh viện, loại vi khuẩn với nhiễm khuẩn huyết do vi khuẩn DTR. Kết luận: Nhiễm khuẩn huyết do vi khuẩn DTR sẽ làm tăng tỷ lệ tử vong và kéo dài thời gian nằm viện. Những bệnh nhân nhiễm khuẩn huyết do vi khuẩn DTR có nguy cơ tử vong bằng 1,76 lần so với các bệnh nhân nhiễm khuẩn huyết không do vi khuẩn DTR với KTC 95% từ 1,26 đến 2,46.

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