鼻腔病与医疗保健相关病与社区获得的自发细菌性腹膜炎:网络元分析
Amna Iqbal1, Manesh Kumar Gangwani1, Azizullah Beran2
1Department of Medicine, University of Toledo Medical Center, Toledo, Ohio, USA.
The American journal of the medical sciences
|July 2, 2023
概括
与社区获得的 (CA-SBP) 和与医疗保健相关的 (HA-SBP) 形式相比,鼻腔自发性细菌性腹膜炎 (N-SBP) 与更高的死亡率和抗生素耐药性有关. 早期识别和针对NSBP的定制指南对于更好的患者结果至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
背景情况:
- 自发细菌性腹膜炎 (SBP) 是肝硬化不补偿的严重并发症.
- 根据获得时间,SBP被分为社区获得 (CA-SBP),医院 (N-SBP) 和医疗保健相关 (HA-SBP) 的类别.
- 了解这些SBP类型的不同结果对于患者管理至关重要.
研究的目的:
- 评估和比较CA-SBP,N-SBP和HA-SBP之间的死亡率和抗生素耐药性模式.
- 为了确定与医院SBP相关的特定风险.
主要方法:
- 系统地搜索多个数据库,直到2022年8月.
- 使用随机效应模型进行双向和网络元分析.
- 使用95%置信区间 (CI) 计算相对风险 (RR).
主要成果:
- 总共分析了14项研究和2302个SBP情节.
- 与HA-SBP和CA-SBP相比,N-SBP的死亡率明显更高.
- 第三代素耐药性在N-SBP与HA-SBP和CA-SBP相比显著增加,以及在HA-SBP与CA-SBP之间.
结论:
- 鼻性SBP与增加的死亡率和抗生素耐药性有关.
- 建议包括早期识别N-SBP患者以进行有针对性的治疗.
- 需要制定针对医院感染的具体指导方针,以优化抗生素耐药性模式并降低死亡率.
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