为了优化经验性抗生素治疗急性移植骨髓炎:一项回顾性多中心研究
Pauline Martinet1, Luca Lanfranco2, Anne Coste1
1Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France; Groupe d'Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l'Ouest (GERICCO), France.
Infectious diseases now
|May 16, 2024
概括
在移植接受者中,急性移植骨髓炎的经验性抗生素治疗需要重新评估. 对常见抗生素的高耐药率需要组合治疗,可能包括阿米卡,以有效管理这些感染.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
- 移植免疫学 移植免疫学
背景情况:
- 急性移植骨髓炎 (AGPN) 是移植接受者 (KTRs) 常见的传染性并发症.
- 目前针对社区获得的 (CA) 和与医疗保健相关的 (HCA) 肌炎的治疗指南可能对KTRs由于特定的耐药性模式而不是最优的.
研究的目的:
- 确定KTRs中AGPN最合适的经验抗生素治疗方法.
- 在KTR中评估CA-和HCA-AGPN中抗生素耐药性的流行率.
主要方法:
- 进行了一项观察性,回顾性,多中心研究.
- 分析了2019年在210名住院的KTR中244次AGPN发作的数据.
主要成果:
- 对于第三代类 (23-47%) 和类 (30-31%),观察到高耐药率.
- 塞费皮姆和皮佩拉西林-塔扎巴克坦也显示出显著的抗药率 (>15%).
- 氨基糖化物和碳烯是唯一具有10%以下耐药率的类别.
结论:
- 标准的经验性尿路感染抗生素由于耐药性高,对KTR中的AGPN是不够的.
- 不建议单独使用推药物进行单一治疗.
- 建议使用组合疗法,可能包括阿米卡,作为更合适的策略.
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