請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/44139
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 張上淳(Shan-Chwen Chang) | |
dc.contributor.author | Li-Fen Kuo | en |
dc.contributor.author | 郭立芬 | zh_TW |
dc.date.accessioned | 2021-06-15T02:41:41Z | - |
dc.date.available | 2014-09-15 | |
dc.date.copyright | 2009-09-15 | |
dc.date.issued | 2009 | |
dc.date.submitted | 2009-08-11 | |
dc.identifier.citation | 1. Sanders, W.E., Jr. and C.C. Sanders, Enterobacter spp.: pathogens poised to flourish at the turn of the century. Clin Microbiol Rev, 1997. 10(2): p. 220-41.
2. Falkiner, F.R., Enterobacter in hospital. J Hosp Infect, 1992. 20(3): p. 137-40. 3. Bennett, S.N., M.M. McNeil, L.A. Bland, M.J. Arduino, M.E. Villarino, D.M. Perrotta, et al., Postoperative infections traced to contamination of an intravenous anesthetic, propofol. N Engl J Med, 1995. 333(3): p. 147-54. 4. Buchholz, D.H., V.M. Young, N.R. Friedman, J.A. Reilly, and M.R. Mardiney, Jr., Bacterial proliferation in platelet products stored at room temperature. Transfusion-induced Enterobacter sepsis. N Engl J Med, 1971. 285(8): p. 429-33. 5. Donnenberg, M.S., Enterobacteriaceae.Mandell, Bennett, & Dolin: Principles and Practice of Infectious Diseases. 6th ed, ed. G.L. Mandell, J.E. Bennett, and R. Dolin. 2005, NEW YORK: Elsevier/Churchill Livingstone. 2567-2586. 6. Liu, C.P., N.Y. Wang, C.M. Lee, L.C. Weng, H.K. Tseng, C.W. Liu, et al., Nosocomial and community-acquired Enterobacter cloacae bloodstream infection: risk factors for and prevalence of SHV-12 in multiresistant isolates in a medical centre. J Hosp Infect, 2004. 58(1): p. 63-77. 7. Paterson, D.L. and R.A. Bonomo, Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev, 2005. 18(4): p. 657-86. 8. Chow, J.W., M.J. Fine, D.M. Shlaes, J.P. Quinn, D.C. Hooper, M.P. Johnson, et al., Enterobacter Bacteremia: Clinical Features and Emergence of Antibiotic Resistance during Therapy. Annals of Internal Medicine, 1991. 115(8): p. 585-590. 9. Kaye, K.S., S. Cosgrove, A. Harris, G.M. Eliopoulos, and Y. Carmeli, Risk Factors for Emergence of Resistance to Broad-Spectrum Cephalosporins among Enterobacter spp. . Antimicrob Agent Chemother, 2001: p. 2628-2630. 10. Schwaber, M.J., C.S. Graham, B.E. Sands, H.S. Gold, and Y. Carmeli, Treatment with a broad-spectrum cephalosporin versus piperacillin-tazobactam and the risk for isolation of broad-spectrum cephalosporin-resistant Enterobacter species. Antimicrob Agents Chemother, 2003. 47(6): p. 1882-6. 11. Kang, C.I., S.H. Kim, W.B. Park, K.D. Lee, H.B. Kim, M.D. Oh, et al., Bloodstream infections caused by Enterobacter species: predictors of 30-day mortality rate and impact of broad-spectrum cephalosporin resistance on outcome. Clin Infect Dis, 2004. 39(6): p. 812-8. 12. Kang, C.I., S.H. Kim, H.B. Kim, S.W. Park, Y.J. Choe, M.D. Oh, et al., Pseudomonas aeruginosa bacteremia: risk factors for mortality and influence of delayed receipt of effective antimicrobial therapy on clinical outcome. Clin Infect Dis, 2003. 37(6): p. 745-51. 13. Leibovici, L., M. Paul, O. Poznanski, M. Drucker, Z. Samra, H. Konigsberger, et al., Monotherapy versus beta-lactam-aminoglycoside combination treatment for gram-negative bacteremia: a prospective, observational study. Antimicrob Agents Chemother, 1997. 41(5): p. 1127-33. 14. Harbarth, S., J. Garbino, J. Pugin, J.A. Romand, D. Lew, and D. Pittet, Inappropriate initial antimicrobial therapy and its effect on survival in a clinical trial of immunomodulating therapy for severe sepsis. Am J Med, 2003. 115(7): p. 529-35. 15. Lin, Y.C., T.L. Chen, H.L. Ju, H.S. Chen, F.D. Wang, K.W. Yu, et al., Clinical characteristics and risk factors for attributable mortality in Enterobacter cloacae bacteremia. J Microbiol Immunol Infect, 2006. 39(1): p. 67-72. 16. Lee, S.O., Y.S. Kim, B.N. Kim, M.N. Kim, J.H. Woo, and J. Ryu, Impact of previous use of antibiotics on development of resistance to extended-spectrum cephalosporins in patients with enterobacter bacteremia. Eur J Clin Microbiol Infect Dis, 2002. 21(8): p. 577-81. 17. Al-Tawfiq, J.A., A. Antony, and M.S. Abed, Antimicrobial resistance rates of Enterobacter spp.: a seven-year surveillance study. Med Princ Pract, 2009. 18(2): p. 100-4. 18. McConkey, S.J., D.C. Coleman, F.R. Falkiner, S.R. McCann, and P.A. Daly, Enterobacter cloacae in a haematology/oncology ward--first impressions. J Hosp Infect, 1989. 14(4): p. 277-84. 19. Gaston, M.A., Enterobacter: an emerging nosocomial pathogen. J Hosp Infect, 1988. 11(3): p. 197-208. 20. John, J.F., Jr., R.J. Sharbaugh, and E.R. Bannister, Enterobacter cloacae: bacteremia, epidemiology, and antibiotic resistance. Rev Infect Dis, 1982. 4(1): p. 13-28. 21. Paterson, D.L., Resistance in gram-negative bacteria: Enterobacteriaceae. Am J Infect Control, 2006. 34(5 Suppl 1): p. S20-8; discussion S64-73. 22. Livermore, D.M., beta-Lactamases in laboratory and clinical resistance. Clin Microbiol Rev, 1995. 8(4): p. 557-84. 23. Siebert, J.D., R.B. Thomson, Jr., J.S. Tan, and L.W. Gerson, Emergence of antimicrobial resistance in gram-negative bacilli causing bacteremia during therapy. Am J Clin Pathol, 1993. 100(1): p. 47-51. 24. Goldstein, F.W., Cephalosporinase induction and cephalosporin resistance: a longstanding misinterpretation. Clin Microbiol Infect, 2002. 8(12): p. 823-5. 25. Dunne, W.M., Jr. and D.J. Hardin, Use of several inducer and substrate antibiotic combinations in a disk approximation assay format to screen for AmpC induction in patient isolates of Pseudomonas aeruginosa, Enterobacter spp., Citrobacter spp., and Serratia spp. J Clin Microbiol, 2005. 43(12): p. 5945-9. 26. Livermore, D.M., Clinical significance of beta-lactamase induction and stable derepression in gram-negative rods. Eur J Clin Microbiol, 1987. 6(4): p. 439-45. 27. Kuga, A., R. Okamoto, and M. Inoue, ampR gene mutations that greatly increase class C beta-lactamase activity in Enterobacter cloacae. Antimicrob Agents Chemother, 2000. 44(3): p. 561-7. 28. Rupp, M.E. and P.D. Fey, Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae: considerations for diagnosis, prevention and drug treatment. Drugs, 2003. 63(4): p. 353-65. 29. Jacoby, G.A. and L.S. Munoz-Price, The new beta-lactamases. N Engl J Med, 2005. 352(4): p. 380-91. 30. Martinez-Martinez, L., S. Hernandez-Alles, S. Alberti, J.M. Tomas, V.J. Benedi, and G.A. Jacoby, In vivo selection of porin-deficient mutants of Klebsiella pneumoniae with increased resistance to cefoxitin and expanded-spectrum-cephalosporins. Antimicrob Agents Chemother, 1996. 40(2): p. 342-8. 31. Thomson, K.S. and E.S. Moland, Cefepime, piperacillin-tazobactam, and the inoculum effect in tests with extended-spectrum beta-lactamase-producing Enterobacteriaceae. Antimicrob Agents Chemother, 2001. 45(12): p. 3548-54. 32. Jett, B.D., D.J. Ritchie, R. Reichley, T.C. Bailey, and D.F. Sahm, In vitro activities of various beta-lactam antimicrobial agents against clinical isolates of Escherichia coli and Klebsiella spp. resistant to oxyimino cephalosporins. Antimicrob Agents Chemother, 1995. 39(5): p. 1187-90. 33. (2005) Performance standards for antimicrobial susceptibilitytesting; fifteenth informational supplement.Wayne, PA: Clinical and Laboratory Standards Institute. 34. Gottlieb, T. and C. Wolfson, Comparison of the MICs of cefepime for extended-spectrum beta-lactamase-producing and non-extended-spectrum beta-lactamase-producing strains of Enterobacter cloacae. J Antimicrob Chemother, 2000. 46(2): p. 330-1. 35. She, D. and Y. Liu, [The expression of AmpC and extended-spectrum beta-lactamases among clinical isolates of enterobacter cloacae and its impact on antibiotics susceptibility]. Zhonghua Yi Xue Za Zhi, 2002. 82(19): p. 1355-8. 36. Paterson, D.L., W.C. Ko, A. Von Gottberg, J.M. Casellas, L. Mulazimoglu, K.P. Klugman, et al., Outcome of cephalosporin treatment for serious infections due to apparently susceptible organisms producing extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory. J Clin Microbiol, 2001. 39(6): p. 2206-12. 37. Levison, M.E., Y.V. Mailapur, S.K. Pradhan, G.A. Jacoby, P. Adams, C.L. Emery, et al., Regional occurrence of plasmid-mediated SHV-7, an extended-spectrum beta-lactamase, in Enterobacter cloacae in Philadelphia Teaching Hospitals. Clin Infect Dis, 2002. 35(12): p. 1551-4. 38. Tzelepi, E., P. Giakkoupi, D. Sofianou, V. Loukova, A. Kemeroglou, and A. Tsakris, Detection of extended-spectrum beta-lactamases in clinical isolates of Enterobacter cloacae and Enterobacter aerogenes. J Clin Microbiol, 2000. 38(2): p. 542-6. 39. Hooper, D.C., Mechanisms of fluoroquinolone resistance. Drug Resist Updat, 1999. 2(1): p. 38-55. 40. Tran, J.H. and G.A. Jacoby, Mechanism of plasmid-mediated quinolone resistance. Proc Natl Acad Sci U S A, 2002. 99(8): p. 5638-42. 41. Friedland, I., L. Stinson, M. Ikaiddi, S. Harm, and G.L. Woods, Resistance in Enterobacteriaceae: results of a multicenter surveillance study, 1995-2000. Infect Control Hosp Epidemiol, 2003. 24(8): p. 607-12. 42. Walsh, T.R., M.A. Toleman, L. Poirel, and P. Nordmann, Metallo-beta-lactamases: the quiet before the storm? Clin Microbiol Rev, 2005. 18(2): p. 306-25. 43. Galani, I., M. Souli, Z. Chryssouli, K. Orlandou, and H. Giamarellou, Characterization of a new integron containing bla(VIM-1) and aac(6')-IIc in an Enterobacter cloacae clinical isolate from Greece. J Antimicrob Chemother, 2005. 55(5): p. 634-8. 44. Giakkoupi, P., L.S. Tzouvelekis, G.L. Daikos, V. Miriagou, G. Petrikkos, N.J. Legakis, et al., Discrepancies and interpretation problems in susceptibility testing of VIM-1-producing Klebsiella pneumoniae isolates. J Clin Microbiol, 2005. 43(1): p. 494-6. 45. National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1990-May 1999, issued June 1999. Am J Infect Control, 1999. 27(6): p. 520-32. 46. Jarvis, W.R. and W.J. Martone, Predominant pathogens in hospital infections. J Antimicrob Chemother, 1992. 29 Suppl A: p. 19-24. 47. Neuhauser, M.M., R.A. Weinstein, R. Rydman, L.H. Danziger, G. Karam, and J.P. Quinn, Antibiotic resistance among gram-negative bacilli in US intensive care units: implications for fluoroquinolone use. JAMA, 2003. 289(7): p. 885-8. 48. Wisplinghoff, H., T. Bischoff, S.M. Tallent, H. Seifert, R.P. Wenzel, and M.B. Edmond, Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis, 2004. 39(3): p. 309-17. 49. Hageman, J.C., S.K. Fridkin, J.M. Mohammed, C.D. Steward, R.P. Gaynes, and F.C. Tenover, Antimicrobial proficiency testing of National Nosocomial Infections Surveillance System hospital laboratories. Infect Control Hosp Epidemiol, 2003. 24(5): p. 356-61. 50. Guggenheim, M., R. Zbinden, A.E. Handschin, A. Gohritz, M.A. Altintas, and P. Giovanoli, Changes in bacterial isolates from burn wounds and their antibiograms: a 20-year study (1986-2005). Burns, 2009. 35(4): p. 553-60. 51. Juanjuan, D., Z. Zhiyong, L. Xiaoju, X. Yali, Z. Xihai, and L. Zhenzhen, Retrospective analysis of bacteremia because of Enterobacter cloacae compared with Escherichia coli bacteremia. Int J Clin Pract, 2007. 61(4): p. 583-8. 52. Fung, C.P., L.S. Wang, Y.C. Juang, C.Y. Liu, and D.L. Cheng, Enterobacter cloacae bacteremia: clinical analysis of 41 cases. Zhonghua Yi Xue Za Zhi (Taipei), 1988. 42(4): p. 297-304. 53. Hsueh, P.R., W.H. Chen, and K.T. Luh, Relationships between antimicrobial use and antimicrobial resistance in Gram-negative bacteria causing nosocomial infections from 1991-2003 at a university hospital in Taiwan. Int J Antimicrob Agents, 2005. 26(6): p. 463-72. 54. Wu, C.J., H.C. Lee, N.Y. Lee, H.I. Shih, N.Y. Ko, L.R. Wang, et al., Predominance of Gram-negative bacilli and increasing antimicrobial resistance in nosocomial bloodstream infections at a university hospital in southern Taiwan, 1996-2003. J Microbiol Immunol Infect, 2006. 39(2): p. 135-43. 55. Dowzicky, M.J. and C.H. Park, Update on antimicrobial susceptibility rates among gram-negative and gram-positive organisms in the United States: results from the Tigecycline Evaluation and Surveillance Trial (TEST) 2005 to 2007. Clin Ther, 2008. 30(11): p. 2040-50. 56. Deal, E.N., S.T. Micek, R.M. Reichley, and D.J. Ritchie, Effects of an alternative cefepime dosing strategy in pulmonary and bloodstream infections caused by Enterobacter spp, Citrobacter freundii, and Pseudomonas aeruginosa: a single-center, open-label, prospective, observational study. Clin Ther, 2009. 31(2): p. 299-310. 57. Jean, S.S., P.R. Hsueh, W.S. Lee, H.T. Chang, M.Y. Chou, I.S. Chen, et al., Nationwide surveillance of antimicrobial resistance among Enterobacteriaceae in intensive care units in Taiwan. Eur J Clin Microbiol Infect Dis, 2009. 28(2): p. 215-20. 58. Szabo, D., F. Silveira, A.M. Hujer, R.A. Bonomo, K.M. Hujer, J.W. Marsh, et al., Outer membrane protein changes and efflux pump expression together may confer resistance to ertapenem in Enterobacter cloacae. Antimicrob Agents Chemother, 2006. 50(8): p. 2833-5. 59. Sanders, W.E., Jr., J.H. Tenney, and R.E. Kessler, Efficacy of cefepime in the treatment of infections due to multiply resistant Enterobacter species. Clin Infect Dis, 1996. 23(3): p. 454-61. 60. Paterson, D.L., Impact of antibiotic resistance in gram-negative bacilli on empirical and definitive antibiotic therapy. Clin Infect Dis, 2008. 47 Suppl 1: p. S14-20. 61. Reinert, R.R., D.E. Low, F. Rossi, X. Zhang, C. Wattal, and M.J. Dowzicky, Antimicrobial susceptibility among organisms from the Asia/Pacific Rim, Europe and Latin and North America collected as part of TEST and the in vitro activity of tigecycline. J Antimicrob Chemother, 2007. 60(5): p. 1018-29. 62. Lockhart, S.R., M.A. Abramson, S.E. Beekmann, G. Gallagher, S. Riedel, D.J. Diekema, et al., Antimicrobial resistance among Gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004. J Clin Microbiol, 2007. 45(10): p. 3352-9. 63. Deal, E.N., S.T. Micek, D.J. Ritchie, R.M. Reichley, W.M. Dunne, Jr., and M.H. Kollef, Predictors of in-hospital mortality for bloodstream infections caused by Enterobacter species or Citrobacter freundii. Pharmacotherapy, 2007. 27(2): p. 191-9. 64. Cosgrove, S.E., K.S. Kaye, G.M. Eliopoulous, and Y. Carmeli, Health and economic outcomes of the emergence of third-generation cephalosporin resistance in Enterobacter species. Arch Intern Med, 2002. 162(2): p. 185-90. 65. Blot, S.I., K.H. Vandewoude, and F.A. Colardyn, Evaluation of outcome in critically ill patients with nosocomial enterobacter bacteremia: results of a matched cohort study. Chest, 2003. 123(4): p. 1208-13. 66. Uzun, O., H.E. Akalin, M. Hayran, and S. Unal, Factors influencing prognosis in bacteremia due to gram-negative organisms: evaluation of 448 episodes in a Turkish university hospital. Clin Infect Dis, 1992. 15(5): p. 866-73. 67. Scarsi, K.K., J.M. Feinglass, M.H. Scheetz, M.J. Postelnick, M.K. Bolon, and G.A. Noskin, Impact of inactive empiric antimicrobial therapy on inpatient mortality and length of stay. Antimicrob Agents Chemother, 2006. 50(10): p. 3355-60. 68. al Ansari, N., E.B. McNamara, R.J. Cunney, M.A. Flynn, and E.G. Smyth, Experience with Enterobacter bacteraemia in a Dublin teaching hospital. J Hosp Infect, 1994. 27(1): p. 69-72. 69. Weischer, M. and H.J. Kolmos, Retrospective 6-year study of enterobacter bacteraemia in a Danish university hospital. J Hosp Infect, 1992. 20(1): p. 15-24. 70. Bonadio, W.A., D. Margolis, and M. Tovar, Enterobacter cloacae bacteremia in children: a review of 30 cases in 12 years. Clin Pediatr (Phila), 1991. 30(5): p. 310-3. 71. Andresen, J., B.I. Asmar, and A.S. Dajani, Increasing Enterobacter bacteremia in pediatric patients. Pediatr Infect Dis J, 1994. 13(9): p. 787-92. 72. Bantar, C., E. Vesco, C. Heft, F. Salamone, M. Krayeski, H. Gomez, et al., Replacement of broad-spectrum cephalosporins by piperacillin-tazobactam: impact on sustained high rates of bacterial resistance. Antimicrob Agents Chemother, 2004. 48(2): p. 392-5. 73. Lesch, C.A., G.S. Itokazu, L.H. Danziger, and R.A. Weinstein, Multi-hospital analysis of antimicrobial usage and resistance trends. Diagn Microbiol Infect Dis, 2001. 41(3): p. 149-54. 74. Jacobson, K.L., S.H. Cohen, J.F. Inciardi, J.H. King, W.E. Lippert, T. Iglesias, et al., The relationship between antecedent antibiotic use and resistance to extended-spectrum cephalosporins in group I beta-lactamase-producing organisms. Clin Infect Dis, 1995. 21(5): p. 1107-13. 75. Ye, Y., J.B. Li, D.Q. Ye, and Z.J. Jiang, Enterobacter bacteremia: Clinical features, risk factors for multiresistance and mortality in a Chinese University Hospital. Infection, 2006. 34(5): p. 252-7. 76. Digiovine, B., C. Chenoweth, C. Watts, and M. Higgins, The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J Respir Crit Care Med, 1999. 160(3): p. 976-81. 77. Bouza, E., M. Garcia de la Torre, A. Erice, E. Loza, J.M. Diaz-Borrego, and L. Buzon, Enterobacter bacteremia. An analysis of 50 episodes. Arch Intern Med, 1985. 145(6): p. 1024-7. 78. Watanakunakorn, C. and J. Weber, Enterobacter bacteremia: a review of 58 episodes. Scand J Infect Dis, 1989. 21(1): p. 1-8. 79. Kim, B.N., S.O. Lee, S.H. Choi, N.J. Kim, J.H. Woo, J. Ryu, et al., Outcome of antibiotic therapy for third-generation cephalosporin-resistant Gram-negative bacteraemia: an analysis of 249 cases caused by Citrobacter, Enterobacter and Serratia species. Int J Antimicrob Agents, 2003. 22(2): p. 106-11. 80. Blot, S., K. Vandewoude, D. De Bacquer, and F. Colardyn, Nosocomial bacteremia caused by antibiotic-resistant gram-negative bacteria in critically ill patients: clinical outcome and length of hospitalization. Clin Infect Dis, 2002. 34(12): p. 1600-6. 81. Charlson, M.E., P. Pompei, K.L. Ales, and C.R. MacKenzie, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis, 1987. 40(5): p. 373-83. 82. Horan, T.C., M. Andrus, and M.A. Dudeck, CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control, 2008. 36(5): p. 309-32. 83. Chow, J.W. and V.L. Yu, Combination antibiotic therapy versus monotherapy for gram-negative bacteraemia: a commentary. Int J Antimicrob Agents, 1999. 11(1): p. 7-12. 84. Knaus, W.A., E.A. Draper, D.P. Wagner, and J.E. Zimmerman, APACHE II: a severity of disease classification system. Crit Care Med, 1985. 13(10): p. 818-29. 85. Lautenbach, E., J.B. Patel, W.B. Bilker, P.H. Edelstein, and N.O. Fishman, Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae: risk factors for infection and impact of resistance on outcomes. Clin Infect Dis, 2001. 32(8): p. 1162-71. 86. Valles, J., E. Calbo, E. Anoro, D. Fontanals, M. Xercavins, E. Espejo, et al., Bloodstream infections in adults: importance of healthcare-associated infections. J Infect, 2008. 56(1): p. 27-34. 87. Tseng, Y.C., J.T. Wang, F.L. Wu, Y.C. Chen, W.C. Chie, and S.C. Chang, Prognosis of adult patients with bacteremia caused by extensively resistant Acinetobacter baumannii. Diagn Microbiol Infect Dis, 2007. 59(2): p. 181-90. 88. Levy, M.M., M.P. Fink, J.C. Marshall, E. Abraham, D. Angus, D. Cook, et al., 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med, 2003. 31(4): p. 1250-6. 89. Dellinger, R.P., M.M. Levy, J.M. Carlet, J. Bion, M.M. Parker, R. Jaeschke, et al., Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med, 2008. 36(1): p. 296-327. 90. Annane, D., E. Bellissant, and J.M. Cavaillon, Septic shock. Lancet, 2005. 365(9453): p. 63-78. 91. Burchard, K.W., D.T. Barrall, M. Reed, and G.J. Slotman, Enterobacter bacteremia in surgical patients. Surgery, 1986. 100(5): p. 857-62. 92. (04/16/2009) Tigecycline for Injection Drug Description. 93. (July 2008) Aztreonam for Injection Drug Description. 94. (08/20/2008) imipenem and cilastatin for injection Drug Description. 95. Jones, R.N., Resistance patterns among nosocomial pathogens: trends over the past few years. Chest, 2001. 119(2 Suppl): p. 397S-404S. 96. Cosgrove, S.E., The relationship between antimicrobial resistance and patient outcomes: mortality, length of hospital stay, and health care costs. Clin Infect Dis, 2006. 42 Suppl 2: p. S82-9. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/44139 | - |
dc.description.abstract | 目的:
評估Enterobacter cloacae菌血症之抗生素治療、死亡率及致死危險因子,並分析發生對第三代cephalosporins具抗藥性的E. cloacae菌血症的相對危險因子。 研究設計、地點及對象: 此研究於國立台灣大學醫學院附設醫院,位於台灣北部的ㄧ家醫學中心,以翻閱病歷的方式進行單中心、回溯性世代分析研究。主要對象為滿18歲成年人,自2007年1月1日至2007年12月31日期間確定有E. cloacae菌血症之病人。 方法: 以個案紀錄表紀錄病人於紙本及電子病歷的變項,包含病人的資本資料、合併症及其他易造成感染的因子、菌血症發作前的感染及醫療處置行為、菌血症發作時相關資料收集、抗生素治療、後續感染、治療結果。本研究的觀察終點是病人於三十天內的死亡率。另外也針對具ceftazidime及cefotaxime抗藥性的E. cloacae進行危險因子分析。 統計方法包含卡方檢定(χ2 test)、無母數檢定(Mann-Whitney U Test)、T檢定(t-test)、費雪檢定(Fisher’s exact test),另外單變項及多變項分析採用線性迴歸、羅吉斯迴歸的方法。存活曲線由Kaplan-Meier method繪製,以Log-rank test比較兩組樣本間之差異。 結果: 共有168位病人感染E. cloacae菌血症,其中107位(63.7%)病人為單一菌血症感染,61位(36.3%)為多重菌血症感染。病人之平均年齡為62.5歲,男與女的比例為1.25:1.0,有89.3 % 病人為院內感染,Charslon’s comorbidity score平均為3分,病人最多的潛在疾病為心血管疾病(55.4%)、其次為癌症(48.2%),平均住院天數為38天,菌血症發作時以敗血症的臨床表現占最多,菌血症發作時的Pitt bacteremia score平均為2分。腹內感染造成之菌血症占最多(40.5%),其次為原發性菌血症(29.8%)。菌血症發作後至接受合適抗生素的時間平均為20.5小時,三十天內的死亡率為26.2%,而單一菌血症病人之三十天內的死亡率為23.4%。單一菌血症之病人與多重菌血症之病人於三十天內的死亡率無差異。 多變項分析結果顯示病人感染抗藥性E. cloacae菌血症的危險因子相對於感染非抗藥性E. cloacae包括:菌血症發作前的住院天數(OR: 1.02; 95% confidence interval ﹝CI﹞: 1.01-1.04; p=0.008)、潛在性呼吸道疾病(OR: 4.99; 95% CI: 1.65-15.18; p=0.005)、菌血症發作前14天使用過β-lactam/β-lactamase inhibitors (OR: 3.17; 95% CI: 1.31-7.71; p=0.01)、菌血症發作前14天有使用過第三代cephalosporins(OR: 18.53; 95% CI: 4.91-69.96; p<0.0001)及菌血症發作前14天有使用過第四代cephalosporins(OR: 7.96; 95% CI: 1.35-46.84; p=0.02);單一菌血症之病人中感染抗藥性E. cloacae的危險因子有呼吸道疾病(OR: 9.71; 95% CI: 2.62-36.02; p=0.0007)、菌血症發作前72小時有中央導管置入(OR: 4.12; 95% CI: 1.19-14.29; p=0.026)及菌血症發作前14天有使用過第三代cephalospins或是第四代cephalosporins(OR: 15.13; 95% CI: 4.32-53.06; p<0.0001)。 全體病人影響三十天內死亡率之危險因子於包括:院內感染(OR: 12.64; 95% CI: 1.07-148.83; p=0.04)、Charslon’s comorbidity score較嚴重(OR: 1.18; 95% CI: 1.002-1.39; p=0.05)、Pitt bacteremia score較嚴重(OR: 1.43;95% CI: 1.22-1.69; p<0.0001)、呼吸道感染(OR: 3.98;95% CI: 1.09-14.54; p=0.04)及腹內感染(OR: 4.27;95% CI: 1.65-11.03; p=0.003);單一菌血症之病人死亡率之顯著危險因子包括:癌症(OR: 6.21; 95% CI: 1.92-20.16; p=0.002)、菌血症發作當時的Pitt bacteremia score較嚴重(OR: 1.48; 95% CI: 1.21-1.80; p=0.0001)。而是否為抗藥性E. cloacae、抗生素起始治療之適當性、或是否延遲適當之抗生素治療皆和死亡預後沒有相關。 結論: 感染E. cloacae菌血症的病人,三十天內的死亡率和病人本身的情況(Charslon’s comorbidity score和Pitt bacteremia score)、感染源(呼吸道感染源及腹內感染源)及院內感染有關,適當性起始抗生素治療或是抗藥性菌株並不會影響病人之預後。另外,發生對ceftazidime及cefotaxime的E. cloacae菌血症與先前使用過第三代、第四代cephalosporins及β-lactam/β-lactamase inhibitors、病人本身有呼吸道疾病、及菌血症發作前的住院天數有關。 關鍵詞: Enterobacter cloacae、菌血症、危險因子、抗藥性、死亡率、適當抗生素治療。 | zh_TW |
dc.description.abstract | Objectives:
The goal of this study is to evaluate the 30-day mortality of Enterobacter cloacae bacteremia and its prognosis factors. The impact of adequate therapy on clinical outcome, and risk factors of third generation cephalosporin-resistant E. cloacae bacteremia were also assessed. Study design and study populations: A retrospective cohort analysis was performed by charts reviewing for all adult patients hospitalized at the National Taiwan University Hospital (NTUH), a medical center in Northern Taiwan, with E. cloacae bloodstream infection between January 1, 2007 and December 31, 2007. Research methods: Data were collected from medical records and computerized databases and documented in the customized case report form. The data retrieved for each patient included patients’profile, underlying diseases, comorbidities and other potential risk factors for infection; previous hospitalization, previous history of E. cloacae bloodstream infection or colonization history, antibiotics exposure before bacteremia onset, clinical presentation when bacteremia onset, antibiotics regimens during treatment period, and clinical response to antibiotic treatment. The primary endpoint was 30 day all-cause mortality. Risk factors of third generation cephalosporin- resistant E. cloacae were also analysed. The statistical methods used included: Chi-Square test, Mann-Whitney U test , T-test, Fisher’s exact test. Risk factors and clinical outcomes were examed using univariate analysis and multivariate logistic regression analysis. Survival curves shown by Kaplan-Meier method were analyzed with Log-rank test. Results: One hundred sixty-eight patients with E. cloacae bacteremia were enrolled in the study, 107 (63.7%) were monomicrobial infections and 61 (36.3%) were polymicrobial infections. One hundred fifty episodes (89.3%) were classified as nosocomial infections. The age of patients ranged from 21 to 89 years (median, 62.5 years). The proportion of male to female patients was approximately 1.25:1.0 (94 v.s 74). Length of stay in hospitals ranged from 1 to 2695 days (median, 37.5 days). Charslon’s comorbidity score ranged from 0 to 11 (median, 3). The most common underlying diseases was cardiovascular diseases (93 episodes, 55.4%), neoplastic diseases (81, 48.21%), renal diseases (56, 33.3%) and GI diseases (55, 32.7%). Intra-abdominal (40.5%) site was the major source of bacteremia of the patients belonged to primary bacteremia. Pitt bacteremia score ranged from 0 to 14 (median, 2) and the clinical presentation at bacteremia onset was sepsis in 89 episodes (53%). Time to receipt effective antibiotic therapy was from 0 to 257.75 hours (median, 20.5 hours). The 30 day all-cause mortality rate was 26.2% (44/168) and was 23.4% (25/107) in patients with monomicrobial bacteremia. There was no significant differences about mortality between monomicrobial and polymicrobial infections. Multivariate analysis showed that length of stay before bacteremia (odds ratio(OR), 1.02; 95% confidence interval ﹝CI﹞, 1.01-1.04; p=0.008), respiratory diseases (OR, 4.99; 95% CI, 1.65-15.18; p=0.005), previous use β-lactam/β-lactamase inhibitors (OR, 3.17; 95% CI, 1.31-7.71; p=0.01), third-generation cephalosporins (OR, 18.53; 95% CI, 4.91-69.96; p=<0.0001)or fourth–generation cephalosporins (OR, 7.96; 95% CI, 1.35-46.84; p=0.02)used prior to E. cloacae bacteremia were significantly associated with cephalosporin-resistant E. cloacae bacteremia. Among patients with monomicrobial infection, respiratory diseases (OR, 9.71; 95% CI, 2.62-36.02; p=0.0007), indwelling catheter (OR, 4.12; 95% CI, 1.19-14.29; p=0.026) or previous usage of third-generation cephalsoporins or fourth-generation cephalosporins (OR, 15.13; 95% CI, 4.32-53.06; p<0.0001) were associated with cephalosporin-resistant E. cloacae bacteremia. Among patients with E. cloacae bacteremia, those with nosocomial infection (OR, 12.64; 95% CI, 1.07-148.83; p=0.04) or higher Charslon’s comorbidity score (OR, 1.18; 95% CI, 1.002-1.39; p=0.05) or higher Pitt bacteremia score (OR, 1.43; 95% CI, 1.22-1.69; p=<0.0001) or respiratory tract infection source (OR, 3.98; 95% CI, 1.09-14.54; p=0.04) or intra-abdominal infection source (OR, 4.27; 95% CI, 1.65-11.03; p=0.003) had an increased risk of mortality. Among monomicrobial infections, those with malignancy (OR, 6.21; 95% CI, 1.92-20.16; p=0.002) or higher Pitt bacteremia score (OR, 1.48; 95% CI, 1.21-1.80; p=0.0001) had an increased risk of mortality. Resistance of E. cloacae, adequacy of antimicrobial treatment, and delayed adequate treatment were not associated with mortality. Conclusions: Nosocomial infection, Charslon’s comorbidity score, Pitt bacteremia score, respiratory tract infection source and intra-abdominal infection source were found to be associated with poor prognosis by multivariate analysis in patients with E. cloacae bacteremia. Risk factors of third-generation cephalosporin-resistant E. cloacae bacteremia were associated with length of stay before bacteremia onset, respiratory diseases, and previous use of any β-lactam/β-lactamase inhibitors, third- or fourth-generation cephalosporins. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T02:41:41Z (GMT). No. of bitstreams: 1 ntu-98-R96451005-1.pdf: 732890 bytes, checksum: 17e3f985c0220dfac226c53fbd880cac (MD5) Previous issue date: 2009 | en |
dc.description.tableofcontents | 中文摘要 I
Abstract IV 圖目錄 X 表目錄 XI 中英對照表 XIII 第一章 緒論 1 第二章 文獻回顧 3 第1節 細菌學 3 第2節 抗藥性機轉 4 第3節 流行病學相關研究 8 2. 3.1. 各地盛行率 8 2. 3.2. 台灣盛行率 9 第4節 Enterobacter spp.體外藥物敏感性試驗 10 第5節 抗生素治療 13 2. 5.1 抗生素治療選擇 13 2. 5.2 抗生素治療之適當性 14 2. 5.3 延遲抗生素治療療法 15 第6節E. cloacae菌血症的感染 15 2. 6.1 E. cloacae菌血症感染的危險因子 15 2. 6.2 Extended-spectrum cephalosporin抗藥性E. cloacae菌血症之危險因子 16 第7節 E. cloacae感染者死亡的預後因子 18 2. 7.1 死亡率 18 2. 7.2 死亡危險因子 18 第三章 研究目的 20 第四章 研究方法 21 第1節 研究架構 21 第2節 研究地點及研究對象 22 4. 2.1 收入條件: 22 4. 2.2 排除條件: 22 第3節 資料收集 23 4. 3.1 病人基本資料 23 4. 3.2 合併症及其他易造成感染之因子 23 4. 3.3 菌血症發作前的感染及醫療處置行為 24 4. 3.4 菌血症發作時相關資料收集 24 4. 3.5 抗生素治療 25 4. 3.6 後續感染 25 4. 3.7 治療結果 26 第4節 名詞定義 26 4. 4.1 院內感染 26 4. 4.2 社區型感染 26 4. 4.3 醫療照護相關感染 26 4. 4.4 免疫抑制劑 27 4. 4.5 臨床表徵 27 4. 4.6 嗜中性白血球低下 27 4. 4.7 經驗治療與確切治療 28 4. 4.8 治療之適當性 28 第5節 統計分析方法 28 第五章 研究結果 30 第1節 描述性統計 30 5. 1.1 研究設計與病人數 30 5. 1.2 病人基本資料 31 5. 1.3 病人合併症 31 5. 1.4 造成感染的潛在因子 32 5. 1.5 先前使用的抗生素 33 5. 1.6 疾病嚴重度及臨床表徵 33 5. 1.7 感染來源 33 5. 1.8 死亡率 34 5. 1.9 E. cloacae體外試驗的抗生素敏感性試驗 37 5. 1.10 抗生素的治療處方 37 5. 1.11 抗生素治療之適當性 41 5. 1.12 抗生素治療適當與否和死亡率之關係 42 5. 1.13 確切性抗生素使用種類和死亡率之關係 44 5. 1.14 延遲使用適當抗生素和死亡率之關係 45 第2節 存活分析 48 第3節 感染抗藥性E. cloacae菌血症之危險因子 54 第4節 感染E. cloacae菌血症之死亡危險因子 65 第六章 討論 76 第1節 感染E. cloacae菌血症之病人族群 76 第2節 抗生素敏感性試驗結果 76 第3節 抗生素治療之適當性 78 第4節 延遲抗生素治療與死亡率之關係 80 第5節 抗生素治療和死亡率之關係 81 第6節 感染對於ceftazidime及cefotaxime皆呈現抗藥性之危險因子 82 第7節 死亡率分析 86 第8節 死亡之危險因子 86 第9節 研究限制 88 6. 9.1 資料收集 88 6. 9.2 研究地點及病人族群 89 6. 9.3 缺乏MIC及相關資料 89 第七章 結論 90 第八章 參考資料 91 圖目錄 圖 4-1 研究流程圖 21 圖 5-1 病人數目 30 圖 5-2 全體病人之存活曲線 49 圖 5-3 多重菌種及單一菌種的存活曲線 50 圖 5-4 全體病人抗藥組及敏感組的存活曲線 50 圖 5-5 單一菌血病人抗藥組及敏感組的存活曲線 51 圖 5-6 全體病人依Pitt bacteremia score的存活曲線 51 圖 5-7 單一菌種病人依Pitt bacteremia score的存活曲線 52 圖 5-8 全體病人依敗血性休克之存活曲線 52 圖 5-9 單一菌種病人依敗血性休克之存活曲線 53 圖 5-10 共167位病人依使用適當性經驗性抗生素治療與否的存活曲線 53 圖 5-11 單一菌血病人107位使用適當性經驗性抗生素與否的存活曲線 54 圖 6-1 使用過第三代cephalosporins及第四代cephalosporins與感染抗藥性E. cloacae的關係 85 表目錄 表 2-1 誘導及stably derepressed 的E. cloacae的MIC 5 表 2-2 抗生素敏感性試驗 12 表 2-3 感染抗藥性E. cloacae的危險因子 17 表 2-4 死亡率的比較 18 表 2-5 相關研究的死亡危險因子 19 表 5-1 病人資料 34 表 5-2 抗生素敏感性試驗 37 表 5-3 臺大醫院治療E. cloacae 菌血症之經驗性抗生素使用處方 38 表 5-4 臺大醫院治療E. cloacae 菌血症之確切性抗生素使用處方 40 表 5-5 經驗性抗生素治療之適當性 41 表 5-6 抗生素治療適當與否和D7死亡率之關係 42 表 5-7 抗生素治療適當與否和D14死亡率之關係 43 表 5-8 抗生素治療適當與否和D30死亡率之關係 43 表 5-9 適當經驗性藥品第三代、第四代抗生素及carbapenems與死亡率之關係 43 表 5-10 適當確切性藥品第三代、第四代抗生素及carbapenems與死亡率之關係 44 表 5-11 確切性抗生素和D30死亡率之關係 45 表 5-12 延遲適當抗生素治療與D7死亡率之關係 47 表 5-13 全體病人及單一菌血病人延遲適當抗生素治療時間與D7死亡率之關係 47 表 5-14 延遲適當抗生素治療與D14死亡率之關係 47 表 5-15 單一菌血病人延遲適當抗生素治療時間與D14死亡率之關係 48 表 5-16 延遲適當抗生素治療與D30死亡率之關係 48 表 5-17 全體病人感染抗藥組的E. cloacae的危險因子分析(單變項分析) 56 表 5-18 全體病人感染抗藥組相對於敏感組的E. cloacae的危險因子分析 59 表 5-19 單一菌血病人感染抗藥組的E. cloacae的危險因子分析(單變項分析) 61 表 5-20 單一菌血病人感染抗藥組相對於敏感組的E. cloacae的危險因子分析 65 表 5-21 全體病人感染E. cloacae 30天內死亡率的危險因子分析 67 表 5-22 全體病人感染E. cloacae 30天內死亡率的危險因子分析 70 表 5-23 單一菌血病人感染E. cloacae 30天內死亡率的危險因子分析 72 表 5-24 單一菌血病人感染E .cloacae 30天內死亡率的的危險因子分析 75 表 6-1 抗生素敏感性測驗結果比較 77 表 6-2 抗生素治療適當與否及預後 79 表 6-3 菌血症發作前14天使用過的第三代cephalosporins及第四代cephalosporins與感染抗藥性E. cloacae的關係 84 | |
dc.language.iso | zh-TW | |
dc.title | 發生抗藥性Enterobacter cloacae菌血症之危險因子及Enterobacter cloacae菌血症之死亡預後因子分析:著重於藥物治療效果 | zh_TW |
dc.title | Risk factors of cephalosporin-resistant Enterobacter cloacae bacteremia and prognosis of patients with Enterobacter cloacae bacteremia with emphasis on antimicrobial regimen | en |
dc.type | Thesis | |
dc.date.schoolyear | 97-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 林淑文(Shu-Wen Lin) | |
dc.contributor.oralexamcommittee | 林慧玲(Fe-Lin Lin),盛望徽(Wang-Huei Sheng) | |
dc.subject.keyword | 菌血症,危險因子,抗藥性,死亡率,適當抗生素治療, | zh_TW |
dc.subject.keyword | Enterobacter cloacae,bacteremia,risk factors,resistance,mortality,adequate antaimicrobial therapy, | en |
dc.relation.page | 106 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2009-08-11 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床藥學研究所 | zh_TW |
顯示於系所單位: | 臨床藥學研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-98-1.pdf 目前未授權公開取用 | 715.71 kB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。