基于在肝移植中与多种耐药细菌殖民的抗生素管理:叙述性审查
Valentina Zuccaro1,2, Paola Giordani2, Francesca Binda3
1Department of Diagnostic, Paediatric, Clinical and Surgical Science, University of Pavia, 27100 Pavia, Italy.
Microorganisms
|January 8, 2025
概括
肝移植后的早期细菌感染,特别是由多药耐药生物体 (MDROs) 引起的细菌感染,具有重大风险. 本综述提出了一种算法,根据MDRO感染风险对患者进行分层,以帮助临床管理.
科学领域:
- 移植手术 移植手术
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 细菌感染是固体器官移植后的一个主要并发症,导致严重的结果,如移植损失和死亡率.
- 早期移植后的细菌感染,特别是那些涉及多药耐药生物体 (MDROs) 的细菌感染,在肝移植接受者中带来了重大临床挑战.
研究的目的:
- 提供肝移植后早期细菌感染的专家审查,特别关注MDROs.
- 制定最佳实践建议来管理这些感染,整合证据和专家共识.
- 解决对MDRO查结果或感染严重程度含糊不清的患者抗生素治疗中的管理"灰色区域".
主要方法:
- 文献综述和当前关于肝移植后早期细菌感染的证据综合.
- 专家建立共识,制定临床建议.
- 在肝移植患者中开发MDRO感染的风险分层算法.
主要成果:
- 确定肝移植患者MDRO感染抗生素管理中的关键挑战.
- 建议基于风险的算法,以指导MDRO感染管理的临床决策.
- 根据现有证据和专家意见的结合,提出建议.
结论:
- 早期细菌感染的有效管理,特别是MDROs,对于改善肝移植接受者的结果至关重要.
- 结构化,风险分层的方法可以帮助优化抗生素治疗,解决临床管理中的不确定性.
- 需要进一步的研究和共识,以完善在移植后环境中对抗MDRO的最佳实践.
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