早期评估血液培养负面性作为抗菌药物管理的潜在支持工具
Giulia Menchinelli1, Alice Oliveti2, Barbara Fiori1
1Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.
Heliyon
|March 25, 2024
概括
血液培养瓶在48小时内呈阴性,在120小时内仍然呈阴性,支持早期抗菌治疗决策. 这可以显著减少抗生素暴露,帮助抗菌药物管理工作.
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
- 抗微生物药物管理委员会
背景情况:
- 血流感染 (BSI) 需要及时诊断和适当的抗菌治疗.
- 目前的血液培养 (BC) 化方案延长至120小时,可能会推迟抗菌治疗决策.
- 优化BC化时间对于有效的患者管理和资源利用至关重要.
研究的目的:
- 为了评估血液培养瓶的48小时化期在确定消极性的可靠性.
- 根据48小时前的结果,评估早期中止抗微生物药物治疗的可能性.
- 量化早期停药对抗生素使用和资源节约的影响.
主要方法:
- 从单个血流感染病例的血液培养数据的回顾性分析.
- 计算BC瓶在化时间0至120小时内保持负值的概率.
- 评估48小时后阴性BC患者的潜在抗生素中止情况.
主要成果:
- 在4901次发作中,82.0%是BC阴性.
- 在48小时后,BC阴性的概率为100.0% (95% CI,99.9-100.0).
- 在67.8%符合条件的患者中,早期停止抗生素治疗可以在不同的AWaRe组中节省5201天的抗生素暴露.
结论:
- 一个48小时的潜伏期终点可靠地表明血液培养的消极性.
- 早期的BC消极性可以通过及时停止治疗来支持抗微生物药物管理.
- 临床判断仍然至关重要,特别是在对BSI.的高度怀疑的情况下.
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