原发性脑脓肿概况及其对生存的影响：一项国际 ID-IRI 研究。
Profiles of Primary Brain Abscesses and Their Impact on Survival: An International ID-IRI Study.
发表日期：2024 Aug 29
作者：
Meyha Sahin, Ali Mert, Ahmet Naci Emecen, Natalija Planinc Strunjas, Lenka Fasanekova, Ayse Batirel, Ilad Alavi Darazam, Shabboo Ansari, Ghazaleh Golchoub Firouzjaei, Roman Stebel, Elif Tukenmez Tigen, Buket Erturk Sengel, Olga Dzupova, Maya Belitova, Maha Abid, Nazife Duygu Demirbaş, Serpil Erol, Halil Kul, Abdullah Umut Pekok, Tülay Ünver Ulusoy, Handan Alay, Zahra Mohtasham Amiri, Antonio Cascio, Mehmet Kürşat Karadağ, Entela Kolovani, Nikolay Mladenov, Ergys Ramosaco, Oğuz Reşat Sipahi, Gamze Şanlıdağ, Amani El-Kholy, Gulay Okay, Natalia Pshenichnaya, Mustafa Serhat Şahinoğlu, Sevil Alkan, Mehmet Özdemir, Bilal Ahmad Rahimi, Gulden Eser Karlidag, Şafak Özer Balin, Anna Liskova, Anas Jouhar, Fahad Almajid, Xhumari Artur, Mehmet Çelik, Asfandiyar Khan, Massimiliano Lanzafame, Andrea Marıno, Arzu Şenol, Serkan Oncu, Mustafa Uğuz, Joanna Zajkowska, Hakan Erdem
来源：
TROPICAL MEDICINE & INTERNATIONAL HEALTH
摘要：
这项针对 331 名原发性脑脓肿 (PBA) 患者的研究旨在了解感染原、诱发因素和结果，重点关注影响死亡率的因素。数据收集自 2010 年 1 月至 2022 年 12 月期间从 16 个国家的 39 个中心收集的数据，以及临床、分析了放射学和微生物学结果及其对死亡率的影响。患者的平均±SD年龄为46.8±16.3岁，其中男性占71.6%。常见症状包括头痛（77.9%）、发烧（54.4%）和局灶性神经功能缺损（53.5%）。革兰氏阳性球菌是主要病原体，草绿色链球菌被确定为最常见的分离微生物。所有患者均接受抗菌治疗，71.6%接受介入治疗。 42天和180天生存率分别为91.9%和86.1%。 42 天死亡率的重要预测因素包括静脉药物成瘾（HR：6.02，95% CI：1.38-26.26）、恶性肿瘤（HR：3.61，95% CI：1.23-10.58）、精神错乱（HR：2.65，95% CI： 1.19-5.88）和不明细菌（HR：4.68，95% CI：1.76-12.43）。 180 天死亡率的重要预测因素包括恶性肿瘤（HR：2.70，95% CI：1.07-6.81）、意识混乱（HR：2.14，95% CI：1.11-4.15）、颞叶受累（HR：2.10，95% CI： 1.08-4.08）和不明细菌（HR：3.02，95% CI：1.49-6.15）。 PBA 的死亡风险超出了感染阶段，影响 42 天和 180 天死亡率的因素不同。静脉吸毒成瘾与早期死亡相关，而颞叶受累与晚期死亡相关。版权所有 © 2024。由 Elsevier Ltd 出版。
This study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality.Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed.The patients had a mean±SD age of 46.8±16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI:1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15).The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality.Copyright © 2024. Published by Elsevier Ltd.