在患有无症状细菌尿症的住院成年人中,从被认为是尿源的细菌血症
Sonali D Advani1, David Ratz2, Jennifer K Horowitz3
1Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina.
无症状细菌性尿症 (ASB) 很少导致细菌病,特别是在精神状态改变 (AMS) 的患者中. 基于风险的方法可以显著减少对ASB不必要的抗生素使用.
科学领域:
- 传染性疾病 传染性疾病
- 内部医学 内部医学
- 临床微生物学 临床微生物学
背景情况:
- 目前的指导方针建议不使用抗生素治疗无症状细菌性尿症 (ASB).
- 然而,ASB经常得到治疗,即使在精神状态改变 (AMS) 并且没有系统感染迹象的患者中也是如此.
研究的目的:
- 为了确定ASB的住院患者中细菌病的患病率.
- 为了确定与这种人群中的细菌病相关的因素.
- 为了估计潜在的抗生素减少,如果一个2%的细菌病风险值被用于ASB治疗.
主要方法:
- 一项对11590名在密歇根州68家医院住院的ASB患者的队列研究 (2017年7月至2022年6月).
- 主要结局:从一个被认为是尿源的细菌病的患病率.
- 用多变量逻辑回归来确定与细菌病相关的因素.
主要成果:
- ASB是常见的,其中72.2%的患者接受抗生素治疗.
- 只有1.4%的ASB患者患有从可能的尿源引起的细菌病.
- 在患有AMS且没有全身症状的患者中,细菌病仅发生在0.7%的患者中.
结论:
- 来自ASB的细菌病很少见,即使在AMS患者中也是如此.
- 经验性抗生素治疗的个性化,基于风险的策略可以大幅减少不必要的ASB治疗.
- 这种方法可以避免高达78.4%的低风险患者接触抗生素.
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