低风险金黄色葡萄球菌菌病患者不需要常规诊断成像:一个多中心,回顾性,队列研究
Marianne M C Hendriks1, Kris S A Schweren1, Ayden Kleij2
1Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
概括
黄金杆菌菌菌病 (SAB) 的风险分层可以指导管理. 在低风险SAB患者中,省略常规成像并没有恶化结果,这表明个性化的方法是可行的.
科学领域:
- 传染性疾病 传染性疾病
- 临床医学 临床医学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 黄金葡萄球菌菌病 (SAB) 管理受益于风险分层,以确定患有转移性感染风险的患者.
- 在低风险SAB中调查转移性感染频率和临床相关性对于优化诊断策略至关重要.
- 评估遗漏常规成像对低风险SAB患者结果的影响,为临床实践提供了信息.
研究的目的:
- 为了确定低风险的黄金杆菌菌菌病 (SAB) 患者转移性感染的频率和临床相关性.
- 评估在低风险SAB患者中省略常规诊断成像是否与不良结果有关.
- 为了支持SAB个性化管理的风险分层.
主要方法:
- 追溯队列研究涉及377名在7家荷兰医院的低风险SAB成年患者.
- 根据特定标准定义低风险SAB,包括医院获得的感染,没有治疗延迟,缺少假肢材料,短时间的细菌性持续时间和快速的脱光.
- 评估的初级结果是由于转移性感染而改变治疗计划,而二次结果是90天无复发的生存率.
主要成果:
- 在377名患者中,298名 (79%) 接受了诊断成像. 需要延长治疗的转移性感染在5.0%的成像患者中被发现.
- 最终确定的诊断证实,只有1.3%的患者患有临床相关的转移性感染.
- 在接受和不接受成像检查的患者中,90天无复发的存活率相似 (81.0%和83.6%).
结论:
- 风险分层是主张管理的黄金杆菌菌菌病 (SAB) 患者.
- 忽略常规成像的先决条件包括后续血液培养,传染病咨询和关键疾病演变审查.
- 在选择的低风险SAB患者中,可以安全地省略例行成像,从而实现个性化管理.
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