抗生素预防在灵活的尿管透镜与负尿培养的抗生素预防
Daniela María Méndez-Guerrero1, Christian Buitrago-Carrascal2, Andrés Felipe Puentes-Bernal2
1Universidad del Rosario Bogotá Colombia.
BJUI compass
|October 11, 2023
概括
延长抗生素预防灵活的尿路结石切除术 (fURS) 增加了下尿路感染 (UTI) 和多药耐药细菌 (MDRB) 的风险,在患有阴性尿培养的患者中. 建议进行标准预防,以减少这些传染性并发症.
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
- 手术预防手术预防.
背景情况:
- 鼻性细菌感染构成重大威胁,需要优化抗生素策略.
- 灵活的尿道结石切除术 (fURS) 是对结石的常见手术,但可能会出现传染性并发症.
- 扩展抗生素预防 (EP) 与标准抗生素预防 (SP) 在患有阴性尿培养 (UC) 患者的fURS后预防感染的作用需要澄清.
研究的目的:
- 为了比较接受fURS的患者与接受EP和SP的阴性UC之间的传染性并发症的发生率.
- 为了确定术后尿路感染 (UTI) 的差异,包括下部尿路感染,上部尿路感染和败血症.
- 根据预防类型,评估术后UC中多药耐药细菌 (MDRB) 隔离的风险.
主要方法:
- 追溯性,观察性,分析性队列研究设计.
- 包括那些成功接受了20毫米小的石头fURS的患者,并提供完整的数据.
- EP和SP组之间的传染性并发症率的比较.
主要成果:
- 整体并发症率为10.3%,其中7.2%患有术后尿道感染.
- 在EP组中,下部泌尿道感染的发生率明显高 (6.8%对2.7%,RR=2.8,p=0.030).
- 在EP组中观察到MDRB隔离的风险较高 (RR=3.1,p=0.009).
结论:
- 在阴性UC患者的fURS扩展抗生素预防增加了下部尿路感染和MDRB的风险.
- 在EP和SP组之间没有发现上部尿路感染或败血症率的显著差异.
- 建议进行标准的60分钟手术前抗生素预防,以尽量减少感染并发症.
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