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在战场创伤患者的Enterobacter cloacae感染特征和结果
William Bennett1,2, Katrin Mende1,3,4, Wesley R Campbell5
1Brooke Army Medical Center, JBSA Fort Sam Houston, Texas, United States of America.
PloS one
|August 29, 2023
概括
战场感染Enterobacter cloacae并没有增加抗生素耐药性或更糟糕的结果,即使连续隔离. 这表明当前的抗生素预防指南可能足以控制这些耐药的阴性菌种感染.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 军事医学 军事医学
背景情况:
- 菌 (Enterobacter cloacae) 是一种已知的具有多药性耐药性,特别是通过AmpCβ-lactamase的格兰阴性细菌.
- 战场上的伤害对感染控制和治疗具有独特的挑战.
- 在这种情况下,了解E.cloacae感染的特征和结果至关重要.
研究的目的:
- 评估与战场相关的Enterobacter cloacae感染的特征,抗生素使用和临床结果.
- 为了比较单个和连续的E.cloacae分离物的患者.
- 评估序列隔离物中抗生素耐药性的发展.
主要方法:
- 从2009年至2014年,对军人患者中E.cloacae感染的回顾性分析.
- 对患有E.cloacae感染的患者与患有其他细菌感染的患者进行比较.
- 对E. cloacae的初始和连续分离物敏感性概况的分析.
主要成果:
- E. cloacae患者的爆发创伤率,冲击指数较高,并且需要更多的初始血液制品.
- 尽管ICU的入院次数较少,但E. cloacae患者的手术诊所次数较多,抗生素治疗时间较长,住院时间较长.
- 在初始和连续隔离之间没有观察到抗生素耐药性的显著增加.
结论:
- 临床结果和抗生素耐药性模式在单个和连续E.cloacae隔离之间没有显著差异.
- 目前的抗击护理和外科预防指导方针,包括诱导AMPC的抗生素,在控制E.cloacae感染方面似乎有效.
- 进一步的研究可能会探索复杂的战场感染的最佳抗生素策略.
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