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术前多种耐药细菌在心脏外科手术中的肠道殖民作用:一项回顾性研究
Alessia Mattei1, Martina Cuccarelli2, Lorenzo Schiavoni1
1Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00127 Roma, Italy.
Journal of clinical medicine
|November 27, 2024
概括
术前通过多耐药 (MDR) 细菌的肠道殖民化不会增加心脏手术患者的风险. 这一发现表明,目前的抗生素预防可能不需要对MDR阳性个体进行调整.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 外科手术的结果
背景情况:
- 多药耐药 (MDR) 细菌对健康构成重大风险,包括增加死亡率和医疗保健成本.
- 抗生素耐药性的增加需要仔细选择抗菌药物和明智地使用新的抗生素.
- 监测和预防医院MDR感染是关键的公共卫生优先事项.
研究的目的:
- 调查手术前MDR肠植入对心脏手术患者手术后结果的影响.
- 确定MDR殖民化是否会影响心脏手术后的重症监护指标和感染率.
主要方法:
- 从2020年1月到2022年5月,成年心脏手术患者的队列研究.
- 纳入标准:积极的手术前MDR肠道定居;排除标准:术后的阳性,年龄<18岁,怀孕,哺乳期.
- 收集的数据:国家外科质量改善计划 (NSQIP) 评分,人口统计,手术类型,重症监护室停留,再入院,死亡率和感染类型 (肺炎,细菌病,SSI).
主要成果:
- 在ICU停留时间,ICU新入院或MDR阳性和对照组之间的死亡率方面没有观察到统计学上显著的差异.
- 在两组中都发现了可比的二次感染率,包括细菌病,伤口感染和肺炎.
结论:
- 手术前用MDR细菌进行直肠定居似乎不会对心脏手术患者的术后结果产生不利影响.
- 对于手术前MDR阳性患者,心脏手术可能可以进行,而不会显著增加风险.
- 目前的手术前抗生素预防策略可能不需要对手术前被确定为MDR阳性患者进行修改.
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