活性查培养对抗卡巴因耐药的Acinetobacter baumannii的临床影响:系统性审查和元分析
Ili Margalit1, Digbijay Kunwar2, Chen Gadot3
1Infectious Diseases Unit, Sheba Medical Center, Ramat Gan, Israel; School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
American journal of infection control
|June 27, 2024
概括
积极查抗卡巴胺抗性菌 (CRAB) 识别了患有侵入性感染风险较高的患者. 然而,目前的数据显示,在减少死亡率或停留时间方面,临床益处有限.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 公共卫生 公共卫生
背景情况:
- 耐卡巴胺的宝曼尼菌 (Acinetobacter baumannii,简称CRAB) 是一种关键的医疗相关病原体,与高死亡率有关.
- 积极查CRAB是一种策略,用于识别携带者,并可能减轻传播和感染.
研究的目的:
- 系统地审查和元分析活跃查培养对CRAB的临床影响.
- 确定CRAB查是否改善了临床结果,以及积极查是否预测了CRAB感染.
主要方法:
- 对比研究的系统审查和元分析.
- 在2024年1月之前进行文献搜索.
- 包括报告临床结果的研究,如死亡率和侵入性CRAB感染.
主要成果:
- 在CRAB携带者中,侵入性CRAB感染率明显高 (OR 11.14).
- 在携带者中,CRAB血流感染率显著增加 (OR 16.23).
- 在侵袭性感染方面观察到高负预测值 (97%);在VAP,LOS或死亡率上没有发现显著差异.
结论:
- 目前,支持积极CRAB查降低患者死亡率的临床益处的证据有限.
- 查结果为CRAB阳性的患者有明显增加患入侵性CRAB感染的风险.
- 虽然非携带证明了高负预测值,但积极查尚未转化为降低患者死亡率.
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