在接收大肠外科手术时接受埃尔塔胺抗菌预防后的术后结果:多中心回顾性队列研究
Christopher J Hostler1,2, Jay Krishnan1, Alice Parish3
1Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University, Durham, NC, USA.
Infection control and hospital epidemiology
|October 4, 2024
概括
对结肠外科手术患者的埃尔塔胺预防与手术部位感染 (SSI) 的风险更高有关. 然而,在Clostridioides difficile感染 (CDI) 或耐卡巴耐药肠道细菌 (CRE) 率中没有发现显著差异.
科学领域:
- 传染性疾病 传染性疾病
- 外科手术的结果
- 抗微生物药物管理委员会
背景情况:
- 术期间的抗生素预防对于在结肠外科手术后预防手术部位感染 (SSI) 至关重要.
- 埃尔塔是用于手术预防的常用卡巴,但它对特定术后结果的影响需要评估.
- 了解埃尔塔尼姆与其他抗生素疗法的比较有效性对于优化患者护理至关重要.
研究的目的:
- 为了比较术后的结果,特别是手术部位感染 (SSI),Clostridioides difficile感染 (CDI) 和耐卡巴胺的肠杆菌 (CRE) 殖民,在接受埃尔塔胺治疗的患者和接受结肠手术替代抗生素预防的患者之间.
- 评估埃尔塔胺使用与关键手术后感染并发症发生率之间的关联.
主要方法:
- 一项多中心回顾性队列研究,涉及7家医院2,109名接受结肠手术的成年患者.
- 患者在2010年1月至2015年9月期间接受了烯或其他抗生素治疗方案,用于术后预防.
- 用逆概率加权的通用线性混合后勤回归模型来分析SSI,CDI和CRE阳性的差异几率.
主要成果:
- 接受埃尔塔尼姆预防治疗的患者与其他疗法患者相比,患上术后SSI的概率增加了统计学上显著的1.56倍 (3.5%对2.5%;OR 1.56,P = .02).
- 在埃尔塔尼姆和非埃尔塔尼姆组之间没有观察到术后CDI的几率有显著差异 (1.8%与2.0%;OR 1.07,P = .78).
- 临床CRE培养的阳性是罕见的,并且在两组之间没有统计学上的差异.
结论:
- 在结肠外科手术患者的外科术期间的埃尔塔胺预防与手术部位感染的发病率更高有关.
- 埃尔塔尼姆的使用没有显示出与Clostridioides difficile感染或耐卡巴尼姆的Enterobacteraciae殖民率的增加有显著的关联.
- 需要进一步的研究来验证这些发现,并探索对结肠外科手术预防中的抗生素选择的影响.
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