在Ivor-Lewis食道切除术后的解剖学泄漏中微生物病原体谱
Andreas Schneider1,2, Seung-Hun Chon3, Philipp Kasper4
1Department of Anesthesiology and Intensive Care Medicine, Kliniken Maria Hilf, Mönchengladbach, Germany.
Surgical infections
|March 10, 2025
概括
消化管切除术后的解剖体泄漏涉及各种细菌和酵母. 有效的经验性抗生素治疗需要考虑肠杆菌,肠球菌和酵母,与 piperacillin-tazobactam,meropenem,或tigecycline 显示低失败率.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 传染性疾病 传染性疾病
背景情况:
- 消化管切除术后的解剖管泄漏是严重的并发症.
- 有效的抗微生物治疗对于管理这些泄漏至关重要.
研究的目的:
- 为了研究微生物病原体频谱在食道切除术后的解剖学泄漏.
- 为了告知最佳的经验抗微生物治疗策略.
主要方法:
- 在Ivor-Lewis食道切除术后,发生了解漏病的患者的回顾性分析.
- 从手术样本,胸管液体,内镜吸液和血液培养物中分析微生物培养物.
主要成果:
- 格拉姆阳性细菌 (病毒性链球菌,肠球菌) 和格拉姆阴性细菌 (肠球菌) 是普遍存在的.
- 酵母也经常被检测到 (43%-64%).
- 多药耐药细菌的低患病率;皮佩拉西林-塔扎巴克坦,梅洛和提格环素在与 echinocandins 结合时显示了 < 10% 的预期失败率.
结论:
- 解剖学泄漏存在广泛的微生物病原体.
- 经验性抗微生物选择应考虑肠杆菌,肠球菌和酵母菌.
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