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常规尿液培养对接受常规年度脊髓损伤评估的人群抗生素使用的影响
Sarah May1, Annette Walder2, Casey Hines-Munson2
1Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Spinal cord
|November 8, 2023
概括
脊髓损伤 (SCI) 的退伍军人每年的尿液培养通常会导致抗生素处方,即使是负面的结果. 这突出了SCI护理中的抗生素管理计划的潜在目标.
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
- 医疗保健服务研究 医疗服务研究
背景情况:
- 退伍军人卫生管理局 (VHA) 要求对所有脊髓损伤和疾病 (SCI/D) 患者进行年度尿液培养.
- 这种查可能导致过度识别和不适当的抗生素治疗无症状细菌尿症.
- 抗生素管理对于管理SCI/D患者至关重要,以防止耐药性.
研究的目的:
- 评估每年评估尿检和随后的退伍军人SCI/D抗生素治疗之间的关联.
- 评估尿液培养结果对VHA内的抗生素处方模式的影响.
- 确定改善SCI/D护理中的抗生素管理的机会.
主要方法:
- 使用国家VHA电子健康记录数据进行的回顾性队列研究.
- 分析了2017年10月1日至2019年9月30日期间接受年度评估的SCI/D退伍军人数据.
- 检查尿液培养结果 (阳性/阴性) 和抗生素处方之间的相关性,在每年遭遇7天内.
主要成果:
- 在9447名患有SCI/D的退伍军人中,有5088人 (54%) 在年度评估期间进行了尿液培养.
- 57%的尿液培养是阳性的,其中大肠杆菌是最常见的生物体.
- 抗生素被处方给13%的积极培养患者和6%的消极培养患者,这表明积极培养和抗生素使用之间存在显著的关联 (p < 0.001).
结论:
- 在每年SCI/D评估期间获得的尿液培养物经常被抗生素处方所遵循.
- 这种做法在SCI患者的抗生素管理计划中代表了一个重要的干预领域.
- 优化尿培养解释和抗生素处方指南对于有效的SCI护理至关重要.
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