早期的抗病毒使用和补充氧气降低了二次细菌感染的风险:一个多中心,嵌套的病例控制研究
1Department of Pulmonary and Critical Care Medicine at the Seventh Medical Center, College of Pulmonary and Critical Care Medicine of the Eighth Medical Center, Chinese PLA General Hospital, Beijing, China; Department of Pulmonary and Critical Care Medicine at the First Medical Center, College of Pulmonary and Critical Care Medicine of the Eighth Medical Center, Chinese PLA General Hospital, Beijing, China.
The Journal of hospital infection
|December 19, 2024
概括
在COVID-19患者中,氧气治疗和早期抗病毒使用可以减少二次细菌感染. 相反,输管养和肠外营养增加了感染风险,指导了重症监护策略.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
背景情况:
- 二次性细菌感染对2019年冠状病毒病 (COVID-19) 患者构成重大威胁.
- 了解影响宿主易感性的治疗策略对于改善患者的治疗结果至关重要.
研究的目的:
- 评估各种治疗策略如何影响COVID-19患者的二次细菌感染风险.
- 确定与增加或减少感染风险相关的特定干预措施.
主要方法:
- 一项嵌套的病例对照研究,涉及中国456名COVID-19患者 (152例,304例对照).
- 倾向性得分匹配 (PSM) 用于控制年龄,性别,疾病严重程度和并发症.
- 该研究分析了二次感染与支持性护理,抗病毒药物和抗菌药物等治疗方法之间的关联.
主要成果:
- 补充氧气 (低流量或高流量,非呼吸器) 显著保护免受二次细菌感染 (OR分别为0.18和0.06).
- 胃管养 (OR: 10.97) 和肠外营养 (OR: 3.97) 与显著增加的感染风险有关.
- 早期使用抗病毒药物 (症状出现后5天内) 也显示出保护作用 (OR:0.09).
结论:
- 在非呼吸器环境中补充氧气和早期的抗病毒药物管理与COVID-19中减少的二次细菌感染有关.
- 亲肠道营养和输管养与这些感染的发病率较高有关.
- 研究结果可以为管理COVID-19患者和预防二次感染的临床决策提供信息.
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