非艾滋病毒患者的肺炎:需要更长时间的预防
Léo Sauvat1, Laure Denis2, Céline Nourrisson3
1Infection Control Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
在非艾滋病毒患者中,肺囊炎肺炎 (PCP) 的死亡率很高. 许多应该接受预防治疗的患者没有接受,强调需要改进指导方针和遵守以防止致命结果.
科学领域:
- 传染性疾病 传染性疾病
- 免疫受损患者的护理
背景情况:
- 肺炎 (PCP) 对非艾滋病毒免疫受损个体具有显著的死亡风险.
- 目前的预防策略依赖于三甲-硫甲醇 (TMP-SMX),但预防指南不一致.
- 在标准化肺囊病预防方案方面缺乏共识.
研究的目的:
- 在非艾滋病毒免疫受损患者中描述PCP病例.
- 评估遵守现有的预防指南.
- 识别当前预防策略中的差距.
主要方法:
- 在2007年至2020年期间诊断出PCP的78名患者的回顾性分析.
- 根据潜在的病理和治疗指南评估先前预防的指示.
- 处方预防与国际疾病协会建议的比较.
主要成果:
- 血液病理 (42%),自身免疫性疾病 (27%) 和器官移植 (17%) 是主要的潜在疾病.
- 只有18%的患者先前接受过预防治疗,在PCP发作期间没有人接受过预防治疗.
- 59%的患者应该按照指导方针进行预防治疗,血液学组的遵守率最低 (72%没有处方).
- 42%的患者需要重症监护,3个月死亡率为20%.
结论:
- 在非艾滋病毒免疫功能低下的患者中,遵守肺囊炎预防指南是不理想的.
- 传染病专家应该制定全面的,个性化的预防指南.
- 改善遵守和量身定制的建议对于减少PCP相关死亡率至关重要.
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