传染病趋势:一项5年回顾性研究

Inês Rego de Figueiredo, J. Ferrão, S. Dias, R. Alves, A. Taulaigo, Mário Ferraz, S. Castro, A. M. Antunes, Cláudia Mihon, A. Lladó, Heidi Heidi Gruner, A. Panarra
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摘要

背景:尽管住院通常是由于慢性病的恶化,但最常见的是由潜在的传染过程引起的。患者通常每年有几次入院,这使他们面临反复感染、发病率增加和出现耐药性微生物菌株的风险。方法:这是一项回顾性的描述性研究,研究对象为五年内入住三级医院医疗病房的所有确诊为传染病的患者。从电子医疗档案中收集有关性别、年龄、自主性、合并症、初级诊断、住院时间、死亡率以及微生物数据监测的信息。结果:共有355名患者符合入选标准。在分析的样本中,平均年龄为78.10±12.47岁。在患者中,57.2%(203)为女性,根据Katz评分,大多数患者被视为依赖性患者。Charlson合并症指数(CCI)的平均得分为6.28±2.74,随年龄增长而增加。主要诊断类别为呼吸道(191例患者:137例肺炎和49例急性支气管炎)和泌尿道(138例患者:69例肾盂肾炎和66例膀胱炎)。尿路感染在女性和依赖性患者中更为常见。只有37.8%的感染者具有微生物分离物:大肠杆菌(28.4%)、铜绿假单胞菌(12.7%)、,和肺炎克雷伯菌(8.2%)。总死亡率为6.77%,以及对进一步改进经验性治疗的抵制。
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Trends in Infectious Diseases: A Retrospective 5-year Study
Background: Although hospital admission is frequently due to the exacerbation of chronic diseases, most often it is caused by an underlying infectious process. Patients often have several admissions per year, making them at risk for recurrent infections, increased morbidity, and the emergence of resistant strains of microorganisms. Methods: This is a retrospective, descriptive study of all patients with an infectious disease diagnosis, who were admitted to the medical ward of a tertiary hospital during a 5-year period. Information was collected from electronic medical files regarding gender, age, autonomy, comorbidities, primary diagnosis, in-hospital length of stay, and mortality as well as microbiological data surveillance. Results: A total of 355 patients fulfilled the inclusion criteria. Amongst the sample analysed, the average age was 78.10±12.47 years. Of the patients, 57.2% (203) were female, with most patients considered as dependent according to Katz score. The average Charlson Comorbidity Index (CCI) score was 6.28±2.74, increasing with age. The main diagnostic categories were respiratory (191 patients: 137 with pneumonia and 49 with acute bronchitis) and urinary tract (138 patients: 69 with pyelonephritis and 66 with cystitis). Urinary tract infections were more frequent in females and in dependent patients. Only 37.8% of infections had a microbiologic isolate: Escherichia coli (28.4%), Pseudomonas aeruginosa (12.7%), and Klebsiella pneumoniae (8.2%). The overall mortality was 6.77%. Conclusions: The frequent in-hospital admission due to infectious diseases makes it imperative to characterise and follow-up on evolution of the disease itself in order to better know the characteristics of community-acquired diseases, establish routes of transmission and outbreak identification, microbiology patterns, and resistance towards further improving empiric therapy.
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