CREPE评分:在社区环境中预测第三代脑素耐药肠杆菌肺炎的预测工具
Krisada Khunkitti1, Wantin Sribenjalux2,3, Waewta Kuwatjanakul4
1Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
一个新的预测分数,CREPE,确定了第三代氨酸耐药肠道细菌 (3GCR EB-CAP) 引起的社区性肺炎的风险因素. 这一分数有助于临床医生在为3GCR EB-CAP选择适当的经验治疗.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 公共卫生 公共卫生
背景情况:
- 在全球范围内,社区获得性肺炎 (CAP) 造成了严重的健康负担.
- 抗菌素耐药性的上升,特别是肠道细菌 (EB),复杂化了CAP治疗.
- 第三代抗素的肠道细菌 (3GCR EB) 在CAP病因学中越来越令人担忧.
研究的目的:
- 确定与3GCR EB-CAP相关的风险因素.
- 开发和验证3GCR EB-CAP的预测得分.
- 帮助选择适合CAP的经验性抗生素治疗.
主要方法:
- 对245名微生物学确认的EB-CAP患者进行了回顾性研究.
- 后勤回归分析以确定3GCR EB-CAP的独立风险因素.
- 开发CREPE (第三代塞法洛斯波林耐药肠道细菌社区获得性肺炎评估) 评分.
主要成果:
- CREPE评分包括最近住院,多药耐药性EB殖民以及最近静脉注射抗生素的使用.
- CREPE评分显示出良好的预测性能,AUC为0.88.
- 截止值为1.75,对3GCR EB-CAP产生了73.5%的灵敏度和84.6%的特异性.
结论:
- CREPE评分是预测3GCR EB-CAP的一个有价值的工具.
- 它可以帮助临床医生优化实证抗生素选择.
- 该得分可能有助于减少在高流行地区过度使用广谱抗生素的情况.
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