治疗重症监护室患者的淋病症:生存的真正改变者是什么?
Bianca Leal de Almeida1, Caroline Agnelli2, Thaís Guimarães3,4
1Instituto do Câncer do Estado de São Paulo, School of Medicine, Hospital Infection Control and Infectious Diseases Service, University of São Paulo, São Paulo 01246-000, Brazil.
Journal of fungi (Basel, Switzerland)
|February 25, 2025
概括
在重症监护室 (ICU) 患有白血病仍然是致命的,尽管治疗进展,死亡率仍然很高. 及时的抗真菌治疗和导管切除等关键干预措施对于改善ICU患者存活率至关重要.
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
- 流行病学 流行病学
背景情况:
- 淋病症在ICU中构成重大威胁,其特点是患病率和死亡率高.
- 尽管治疗方面取得了进展,但患有白血病的重症患者的治疗结果仍然很差.
研究的目的:
- 评估巴西重症监护室中候群病的流行病学,临床管理和死亡率预测因素.
- 为了比较两个不同的时间段 (2010-2012年和2017-2018年) 的结果,以确定趋势.
主要方法:
- 一项多中心前性监测研究,涉及巴西11家三级医院的314名患有白血病的重症患者.
- 数据收集包括患者的人口统计,致病性Candida物种,治疗策略和结果.
- 统计分析,包括多变量分析,用于确定死亡率预测因素.
主要成果:
- 候选血病的总死亡率为60.2%,在研究期间之间没有显著变化.
- 最常见的物种是Candida albicans,其次是C. tropicalis和C. glabrata.
- 埃奇诺坎丁的使用增加了,但70%的患者没有作为第一线治疗接受它们. 导管切除与改善的生存率有关.
结论:
- 候选血病管理指南的遵守存在持久性差距,包括延迟的 echinocandin 启动和导管切除.
- 不充分的治疗和血管活性药物的使用与死亡率增加有关.
- 加强及时坚持 echinocandin 治疗和迅速切除导管对于改善患有候选血症的 ICU 患者的生存率至关重要.
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