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实施测试,诊断和抗生素管理在怀孕期间无症状细菌性尿症的算法

Sarah B Bergbower¹, Antonio F Saad², Natalie M Williams-Bouyer³

¹Department of Clinical Laboratory Sciences, The University of Texas Medical Branch, Galveston, TX (Bergbower and Rajendran); Department of Life Sciences, Illinois Eastern Community Colleges, Olney Central College, Olney, IL (Bergbower).

American journal of obstetrics & gynecology MFM

|October 7, 2024

概括

一个基于证据的算法显著改善了怀孕妇女无症状细菌尿的诊断和治疗,减少了不必要的抗生素使用和培养不足. 这提高了产科的患者护理.

科学领域:

产科和妇科产科和妇科
临床微生物学临床微生物学
传染性疾病传染性疾病

背景情况:

无症状细菌尿 (ASB) 影响孕妇,增加早产等风险.
目前尿液分析测量棒的解释缺乏明确的指导方针,导致潜在的过度治疗或治疗不足.
对ASB的白细胞雌激酶查的准确性较低,需要更好的诊断方法.

研究的目的:

开发和评估一种基于证据的算法,用于孕妇患者的尿液分析解释.
改善ASB的诊断,培养利用和抗生素管理.
评估算法对临床决策和患者结果的影响.

主要方法:

怀孕患者的回顾性和前性医疗记录审查 (≥18年,>20周怀孕).
开发一个教育算法,用于尿分析解释,培养和治疗决策.
使用统计分析 (chi-square,概率比率) 对算法实施前后数据进行比较.

主要成果:

算法实施显著减少了培养不足 (43.0%至29.5%) 和抗生素过度处方 (1.6%至0.8%).
在实施后,ASB患病率下降了近60% (16.3%至6.7%).
算法偏差与患者不良结果之间没有发现显著的关联.

结论:

基于证据的算法与临床决策有很强的一致性,增强了产科ASB管理.
算法遵守与更谨慎的抗生素处方实践有关.
该算法显示了改善孕妇群体患者护理和抗生素管理的潜力.

关键词:

临床实验室科学博士学位测量棒测量棒测量棒白细胞化酶是白细胞化酶.医疗中心的关心点孕妇患者孕妇患者不充分利用,使用不足.尿液分析尿液分析尿路感染尿路感染尿液培养是一种文化.

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