感染碳青霉烯耐药的肠杆菌科细菌患者全因死亡的Meta分析

发布时间：2018-04-25 08:43

本文选题：耐碳青霉烯肠杆菌科细菌 + 全因死亡　；参考：《南京医科大学学报(自然科学版)》2016年12期

【摘要】：目的 :评价耐碳青霉烯肠杆菌科细菌感染患者全因死亡风险。方法 :检索Pubmed数据库、Embase数据库,并辅以文献追溯、手工检索,检索时间为2001年1月1日至2015年12月31日。纳入同时含有碳青霉烯耐药肠杆科细菌(CRE)及碳青霉烯敏感的肠杆菌细菌(CSE)的临床特征及预后的研究。采用Stata14.0软件进行文献数据进行分析,并评价Meta分析结果的稳定性和发表偏倚。结果:16项研究符合纳入标准,包括2 916例患者(CRE感染797例,CSE 2 119例)。根据纳入研究的设计类型分为队列研究、病例对照研究;根据感染患者细菌检出的标本类型分为血流感染组亚组、综合感染类型亚组(包括尿液、血液、痰等)。队列研究组的CRE感染全因死亡的相对危险度(risk ratio,RR)为2.44(95%CI:1.96~3.03,I2=16.1%,P_(heterogeneity)=0.312);血流感染亚组的RR为2.07(95%CI:1.59~2.69,I2=0.0%,P_(heterogeneity)=0.511);综合感染类型亚组的RR为3.35(95%CI:2.25~4.99,I2=0.0%,P_(heterogeneity)=0.868)。病例对照组的比值比(odds ratio,OR)为2.30(95%CI:1.49~3.55,I2=53.5%,P_(heterogeneity)=0.018);血流感染亚组的OR为2.85(95%CI:1.66~4.90,I2=60.8%,P_(heterogeneity)=0.018);综合感染类型亚组的OR为1.46(95%CI:0.73~2.90,I2=25.2%,P_(heterogeneity)=0.261)。结论 :CRE患者病死率明显高于CSE患者,血流感染与患者死亡是密切相关的。
[Abstract]:Objective: To evaluate the risk of all cause death in patients with carbacylacillin resistant Enterobacteriaceae. Methods: retrieving Pubmed database, Embase database, and supplementing literature traceability, manual retrieval, and retrieval time from January 1, 2001 to December 31, 2015. The inclusion of carbapenem resistant Enterobacteriaceae (CRE) and carbapenem sensitive Enterobacteriaceae The clinical characteristics and prognosis of bacteria (CSE) were analyzed with Stata14.0 software, and the stability and publication bias of the results of Meta analysis were evaluated. Results: 16 studies were in conformity with the inclusion criteria, including 2916 patients (797 cases of CRE infection, and 2119 cases of CSE). According to the study, the samples were divided into subgroup of blood flow infection group, subgroup of comprehensive infection type (including urine, blood, phlegm, etc.). The relative risk of CRE infection (risk ratio, RR) in the cohort study group was 2.44 (95%CI:1.96~3.03, I2=16.1%, P_ (heterogeneity) =0.312), and the RR of the blood stream infection subgroup was 2.07 (95 %CI:1.59~2.69, I2=0.0%, P_ (heterogeneity) =0.511); RR in the subgroup of comprehensive infection type was 3.35 (95%CI:2.25~4.99, I2=0.0%, P_ (heterogeneity) =0.868). The ratio Ratio of the case control group was 2.30. Eneity) =0.018); the OR of the subgroup of comprehensive infection type was 1.46 (95%CI:0.73~2.90, I2=25.2%, P_ (heterogeneity) =0.261). Conclusion: the mortality of CRE patients was significantly higher than that of CSE patients, and the blood flow infection was closely related to the death of the patients.

【作者单位】：南京医科大学附属无锡市第二人民医院检验科;
【分类号】：R446.5

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