在患者中,从血培养中分离出来的病原性与开始性格拉姆阳性细菌生物的预测因子
Arjun Sharma1, Marion Elligsen2, Nick Daneman1,3
1Department of Medicine, University of Toronto, Toronto, ON, Canada.
Antimicrobial stewardship & healthcare epidemiology : ASHE
|December 29, 2023
概括
患有恶性瘤,败血症得分,胃潰瘍疾病和免疫抑制等患者因素预测血液培养中的病原性格拉姆阳性细菌. 这些发现有助于临床医生确定经验治疗需求和抗菌药物管理.
科学领域:
- 临床微生物学 临床微生物学
- 传染性疾病 传染性疾病
- 医学诊断 医学诊断 医学诊断
背景情况:
- 血培养中的格拉姆阳性细菌可能是污染物或病原体,延迟了24小时以上的物种识别.
- 区分污染物和病原体对于适当的临床管理和抗微生物治疗至关重要.
研究的目的:
- 识别患者特异性变量,预测从血培养中分离致病菌与污染物格兰氏阳性细菌的分离.
- 帮助临床医生在早期评估格兰氏阳性细菌血培养结果时提供帮助.
主要方法:
- 在5年时间内对成人住院患者进行回顾性队列研究.
- 分析了260个独特的格拉姆阳性细菌血培养结果.
- 利用单变量和多变量模型来识别预测因素.
主要成果:
- 恶性病 (aOR 2.78),快速败血症相关器官衰竭评估 (qSOFA) 评分增加 (aOR 2.25),胃潰瘍疾病 (aOR 5.63) 和先前的免疫抑制 (aOR 3.80) 与致病性格拉姆阳性细菌有关.
- 确定的特定病原体包括Clostridium和Listeria物种.
结论:
- 预测因素可以帮助临床医生决定何时在血培养中对血型阳性细菌进行经验治疗.
- 这些预测因素支持针对负责任的处方的抗微生物管理干预措施.
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