连续前列腺活检患者的抗生素耐药性:风险因素和对临床结果的影响
Alex J Xu1, Sameer Thakker2, Vyom Sawhney2
1Department of Urology, NYU Langone Health, New York, New York, USA.
The Canadian journal of urology
|February 24, 2024
概括
复制前列腺活检 (PBx) 与西普罗素预防增加了对西普罗素的耐药性. 活检前直肠培养 (RCx) 对于识别耐药性和指导治疗至关重要,特别是在糖尿病患者或之前活检的患者中.
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
- 医学微生物学 医学微生物学
背景情况:
- 抗 Ciprofloxacin 耐药性是前列腺活检 (PBx) 程序中日益关注的一个问题.
- 了解风险因素和连续暴露的影响对于患者管理至关重要.
研究的目的:
- 为了评估在接受重复前列腺活检的患者中抗素耐药性发展的速度.
- 为了确定与西普洛素耐药性相关的风险因素.
- 评估抗生素耐药性对手术后并发症的影响.
主要方法:
- 从743名接受PBx (1/1/20161/15/2021) 的男性手术前直肠培养 (RCx) 数据的回顾性分析.
- 后勤回归用于识别抗生素耐药性的风险因素.
- 对西普洛素敏感和耐药患者之间的并发症率的比较.
主要成果:
- 最初的RCx显示了22%的西普洛素耐药性.
- 耐药性的风险因素包括糖尿病,之前的PBx>2,以及之前使用西普洛素.
- 第一次活检后的新耐药率为17.2%,第二次活检后为9.1%.
- 在活检之间使用非齐普罗夫洛克萨抗生素可以防止抗药性发展.
- 抗生素耐药性并没有显著影响并发症率.
结论:
- 针对PBx的连续抗生素预防有助于对西普洛素的耐药性.
- 活检前RCx对于重复手术至关重要,以指导适当的抗生素选择.
- 替代抗生素可以减轻耐药性的发展.
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