在格拉姆阴性细菌症中出现初级头素耐药性的风险
Princy John1, Sona Shahbazian2, William D Lainhart3
1Banner Health.
概括
临床因素,如先前的感染或机械通风,预测在格拉姆阴性细菌血症中对素的耐药性. 识别这些危险因素有助于指导适合的抗生素选择,用于阴性感染.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 格拉姆阴性细菌症是一个重大的临床挑战.
- 素是常见的第一线药物,但耐药性正在增加.
- 了解抵抗驱动因素对于有效治疗至关重要.
研究的目的:
- 为了确定与头素耐药性相关的临床风险因素.
- 为了分析Escherichia coli*,Klebsiella pneumoniae*,Enterobacter cloacae*和Pseudomonas aeruginosa*细菌的耐药性模式.
- 为了告知抗生素管理策略.
主要方法:
- 400名成年患有格拉姆阴性细菌病的成年患者的回顾性队列研究.
- 对378例病例的分析,重点关注对氏或氏的耐药性.
- 后勤回归以确定头素耐药性的预测因素.
主要成果:
- 耐药性的重要风险因素包括先前感染 (6个月内),机械呼吸,半和结合组织疾病.
- 这些因素与头素耐药性增加的几率有关 (ORs从3.00到3.77不等).
- 多变量分析证实了这些预测因素的统计学意义.
结论:
- 没有确定的风险因素的患者可能是适合使用塞夫或塞费皮姆的候选人.
- 建议低风险患者避免使用碳烯和较新的宽谱药物.
- 这种方法可以帮助对抗微生物药物进行管理,并保护新的药物.
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