在急性胆道炎中对甲不敏感的细菌血症的危险因素
Katsuhiro Onishi1, Hiroshi Morioka2, Takahiro Imaizumi3
1Department of Pharmacy, Komaki City Hospital, 1-20 Jobushi, Komaki, Aichi, 485-8520, Japan; Infection Control Team, Komaki City Hospital, 1-20 Jobushi, Komaki, Aichi, 485-8520, Japan.
概括
急性胆道炎中对甲不敏感的细菌病的危险因素包括糖尿病,癌症和恶性胆道阻塞. 根据病因学和患者背景量身定制经验疗法至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
背景情况:
- 根据2018年东京指南,对急性胆道炎 (AC) 建议使用Cefmetazole (CMZ).
- 在AC中CMZ非易感性 (CMZ-NS) 细菌病的危险因素尚未确定.
研究的目的:
- 在AC中调查CMZ-NS细菌病的危险因素.
- 在AC患者中评估与CMZ-NS细菌病相关的死亡率.
主要方法:
- 对165名细菌性AC患者进行了回顾性观察性研究 (2019年4月至2023年3月).
- 对CMZ-NS细菌病风险因素的单变和调整后勤回归分析.
- 基于阻塞类型,CMZ易感性和初始治疗的死亡率比较.
主要成果:
- 在27.9%的患者中发生CMZ-NS细菌病.
- 糖尿病,肝胆胰腺癌,恶性胆道阻塞和内缩切除术是CMZ-NS细菌病的重要危险因素.
- 与胆道结石相比,患有恶性胆道阻塞的AC患者的死亡率更高;在有CMZ-NS细菌病和适当抗生素的胆道结石患者中没有死亡.
结论:
- 糖尿病,癌症史,恶性胆道阻塞和先前的内镜截切术增加了AC中CMZ-NS细菌病的风险.
- 对AC的经验性治疗应考虑病因学和患者的背景,而不是疾病的严重程度.
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