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在心脏植入可植入电子设备植入之前,黄金葡萄球菌的脱殖:评估手术前的产量

Yana Kakzanov¹, Yamama Alsana², Tal Brosh-Nissimov³

¹Department of Cardiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.

The Israel Medical Association journal : IMAJ

|November 13, 2024

概括

使用mupirocin进行例行 Staphylococcus aureus (SA) 解殖并没有显著减少心脏植入式电子设备感染 (DRI). 需要进一步的前性研究来证实SA脱殖的作用在预防CIED感染.

科学领域:

心脏病学心脏病学
传染性疾病传染性疾病
医疗器械技术医疗器械技术

背景情况:

心脏植入式电子设备 (CIED) 携带与设备相关的感染 (DRI) 的风险,金黄色葡萄球菌 (SA) 是早期感染和细菌病的常见原因.
虽然鼻子mupirocin和赫西丁洗在其他外科领域显示出希望,但它们在预防CIED感染方面的有效性尚未得到充分证实.

研究的目的:

评估Staphylococcus aureus (SA) 脱殖的影响,在接受CIED手术的患者中,与设备相关的感染 (DRI) 的发生率.

主要方法:

一项回顾性,单中心观察性研究比较了2020年3月至2022年3月间接受CIED干预的患者的DRI率.
所有患者都接受了标准的手术前抗生素和赫西丁清洗皮肤. 从2021年3月起,一个子组接受了SA脱殖民的mupirocin额外的预治疗.
在标准护理组 (组1) 和mupirocin组 (组2) 之间比较了植入后六个月内DRI率.

主要成果:

该研究包括276名患者;五名 (1.8%) 在六个月内发展DRI. 80%的这些手术是用于心脏再同步治疗.
第1组 (n=177) 有4例DRI病例 (2.2%),包括口袋感染和1例甲素敏感性SA内心炎.
第二组 (n=99) 有一个DRI病例 (1%),是一种晚发性链球菌. 失光性内心炎 (P = NS). 失光性内心炎 (P = NS). 失光性内心炎

结论:

在CIED程序中,与指导方针指导的协议一起,与mupirocin进行例行 Staphylococcus aureus (SA) 脱殖,并没有显著改变设备相关感染 (DRI) 率.
需要进行更大规模的前性研究,以最终评估常规SA脱殖的预防作用在CIED干预中.

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