无心病的临床特征:韩国的一项多中心回顾性研究
Seulki Kim1,2, Hye Jin Shi3, Cheon-Hoo Jeon4
1Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
Infection & chemotherapy
|September 7, 2023
概括
无心脏病经常被诊断为非免疫功能受损的个体,只有26.7%的人接受了适当的治疗. 改进的诊断方法和抗生素选择对于管理这种罕见的感染至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 临床医学 临床医学
背景情况:
- 无心病是一种罕见但严重的感染,由于细菌培养物识别速度缓慢,因此难以诊断.
- 了解韩国无心脏病的特征和治疗疗效至关重要.
研究的目的:
- 调查韩国无心病的临床特征.
- 评估当前无心脏病治疗方法的适用性和充分性.
主要方法:
- 在5个韩国医疗机构对微生物学证实无心脏病例 (2011-2021) 的回顾性研究.
- 根据物种,经验治疗 (trimethoprim-sulfamethoxazole或linezolid) 和敏感性测试,定义了适当的抗生素选择.
- 适当的治疗持续时间在3至12个月之间,以器官参与为指导.
主要成果:
- 分析了30名患者 (60%是男性,平均年龄为70.5岁);40%的人具有免疫功能受损的状态.
- 只有30%的患者在推的时间内接受了最佳治疗;25%的免疫功能低下患者得到了适当的剂量.
- 皮肤和软组织感染最常见 (30%);诺卡迪亚物种在平均6天内培养,N. farcinica是最常见的隔离物 (23.3%).
结论:
- 与常见假设相反,显著比例 (60%) 的无心脏病患者没有免疫功能受损.
- 仅有26.7%的患者得到了适当的治疗,这归因于诊断延迟,意识低,以及抗生素选择方面的挑战.
- 不管免疫状况如何,在复发性皮肤,软组织,肌肉骨或呼吸道感染中怀疑无心病,需要高度的临床怀疑和强大的微生物学支持,以便在韩国进行准确的诊断和治疗.
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