什么时候需要使用万科米辛预防? 造成MRSA手术部位感染的危险因素
Cynthia T Nguyen1, Rachel Baccile2, Amanda M Brown3
1Department of Pharmacy, University of Chicago Medicine, Chicago, IL, USA.
Antimicrobial stewardship & healthcare epidemiology : ASHE
|February 28, 2024
概括
范科米辛预防常常被过度使用,用于预防耐甲基黄金葡萄球菌 (MRSA) 手术部位感染 (SSI). 以前的MRSA殖民和关节/膝关节置换是关键的风险因素,而不是与医疗保健相关的特征.
科学领域:
- 传染性疾病 传染性疾病
- 手术部位感染的预防 手术部位感染的预防
- 抗微生物药物管理委员会
背景情况:
- 目前的指导方针建议将万科米辛保留给耐美西林黄金葡萄球菌 (MRSA) 殖民的患者.
- 由于感知MRSA风险和与医疗保健相关的因素,科米辛预防常常被过度使用.
- 确定MRSA手术部位感染 (SSI) 的特定风险因素对于优化预防策略至关重要.
研究的目的:
- 确定与MRSASSI相关的独立风险因素.
- 为了提供更有针对性的万科米辛预防建议.
- 为了减少不必要的万科米辛使用和减轻抗菌素耐药性.
主要方法:
- 一个单中心,病例控制研究进行了八年.
- 术后MRSASSI患者与非MRSASSI患者进行了比较.
- 分析了42个人口,医疗和外科特征.
主要成果:
- 在441名患者中发生了23例MRSASSI (100例SSI中5.2例).
- 独立的MRSASSI风险因素包括先前的MRSA殖民/感染 (OR 9.0) 和关节/膝关节置换手术 (OR 3.8).
- 血液透析,先前和长时间住院没有与MRSASSI有关.
结论:
- 患有MRSA殖民/感染的患者,MRSASSI的几率明显更高.
- 部和膝盖置换手术与MRSASSI的几率增加有关.
- 研究结果支持将万科米辛保留给MRSA殖民患者和接受关节/膝关节置换的患者,特别是在没有例行监测的情况下.
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