在紧急和选择性穿尿道手术中选择抗菌预防:土耳其的敏感性模式
Tanju Keten1, Melih Balci2, Ünsal Eroğlu1
1Department of Urology, University of Health Sciences, School of Medicine, Ankara Bilkent City Hospital, Ankara-Türkiye.
概括
目前用于穿尿道手术的抗生素预防表明对常见细菌的覆盖范围较差. 泌尿科医生应根据局部耐药性模式来个性化选择抗生素,以有效预防.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 过尿道手术带有尿路感染的风险.
- 适当的抗微生物预防对于预防这些感染至关重要.
- 目前的指导方针建议使用特定的抗生素进行预防.
研究的目的:
- 评估当前用于穿尿道手术的抗微生物预防的疗效.
- 确定最适合用于预防的抗微生物药物.
- 评估常见尿路病原体的抗生素敏感性模式.
主要方法:
- 来自土耳其五家医院的尿液培养和抗生素敏感性的回顾性分析 (2021年3月至2022年3月).
- 包括1450名接受紧急或选择性尿道穿手术的患者.
- 排除最近住院或使用抗生素的患者.
主要成果:
- 最常见的病原体是大肠杆菌 (50.1%),肺炎菌 (12.6%),肠杆菌 (8.6%) 和肺炎菌 (6.1%).
- 对推的预防药物的敏感率有很大差异,其中塞费皮姆 (87.1%) 和安皮西林+苏尔巴克坦 (84%) 的疗效更高.
- 许多常被推的抗生素的覆盖率低于最佳 (例如,cefixime 38.4%, ceftriaxone 43%).
结论:
- 目前的抗微生物预防指南可能无法充分覆盖穿尿道手术中普遍存在的病原体.
- 建议基于患者的抗生素预防,考虑到局部耐药性数据.
- 泌尿科医生必须根据不断变化的抗菌素耐药性模式调整抗生素预防方案.
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