无法解释的低温症与急诊室的细菌感染有关
Arthur Baisse1, Simon Parreau2, Stéphanie Dumonteil2
1Emergency Department, Limoges University Hospital Center, F-87042 Limoges, France.
The American journal of emergency medicine
|July 1, 2023
概括
在急诊室的低温患者中,社区获得的细菌感染很常见. 细胞中C反应蛋白 (CRP) 水平和中性细胞与淋巴细胞计数比率 (NLCR) 有助于诊断这些感染.
科学领域:
- 紧急医疗 紧急医疗
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 在急诊室的低温是感染的标志物.
- 早期识别和抗生素治疗对于改善患者预后至关重要.
- 这项研究调查了低温ED患者的细菌感染患病率和诊断标志物.
研究的目的:
- 确定ED患者中社区获得的细菌感染的患病率.
- 评估细菌感染常规生物标记物的诊断准确性.
- 确定可靠的生物标志物来诊断这种患者群体的细菌感染.
主要方法:
- 对患有低温症 (体温<36.0°C) 的成年ED患者进行了回顾性单中心研究.
- 排除明显导致低温或病毒感染的患者.
- 基于源,微生物学和对抗生素的反应来诊断细菌感染;使用后勤回归和ROC曲线分析生物标志物.
主要成果:
- 在209名被研究的患者中,28%的患者被诊断出细菌感染,主要是格拉姆阴性.
- C-反应蛋白 (CRP) 显示曲线下的面积 (AUC) 为0.82.
- 多变量分析确定CRP≥50 mg/L和中性细胞与淋巴细胞计数比 (NLCR) ≥10作为细菌感染的独立预测因素.
结论:
- 在无法解释的低温病例中,向ED提交的诊断中,社区获得的细菌感染占三分之一.
- CRP水平和NLCR是诊断低温患者细菌感染的宝贵工具.
- 这些生物标志物可以帮助临床医生早期识别和管理细菌感染.
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