评估由格拉姆阴性细菌引起的呼吸器相关肺炎的抗生素治疗
Raj Malhotra1, Helen Horng2, Stephanie Bonne1
1Department of Surgery, Division of Trauma and Critical Care Surgery, Rutgers NJMS, Newark, NJ, United States of America.
Surgery open science
|October 4, 2023
概括
复发性呼吸器相关性肺炎 (VAP) 在重症监护病房中很常见,即使在长期使用抗生素治疗氏阴性细菌 (GNB) 感染时也是如此. 需要进一步的研究,以找到最佳的治疗方法,以减少感染复发.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 呼吸机相关的肺炎 (VAPs) 是重症监护室 (ICU) 的重要并发症,增加了患者的发病率和死亡率.
- 阴性细菌 (GNR) 是常见的致病原体,导致VAPs,长时间的抗生素疗程 (10-14天) 传统上是标准的护理.
研究的目的:
- 评估创伤患者中复发GNR VAP的风险因素.
- 评估GNR VAPs当前抗生素治疗持续时间的有效性.
主要方法:
- 在2019年2月至2022年5月期间,对创伤患者进行了回顾性审查,这些患者在2019年2月至2022年5月期间发展了VAP.
- 分析患者人口统计数据,损伤特征,VAP细节 (病原体,抗生素,持续时间) 和复发率.
- 单个与多个GNR VAP事件的比较.
主要成果:
- 在50名创伤患者中,有11名患有GNR VAP.
- 六名患者出现了复发的GNR感染,包括*Pseudomonas aeruginosa*和*Enterobacter aerogenes*.
- 接受10天抗生素治疗的半数患者出现了复发,在微生物学或单次和复发发作的持续时间之间没有显著差异.
结论:
- 尽管长期服用抗生素治疗,但GNR VAP的复发仍然是一个令人担忧的问题.
- 需要进一步调查以确定最佳的治疗策略,以尽量减少ICU患者的VAP复发.
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