感染性疾病咨询改善了白血病治疗:基于人口的队列研究
Samuel Bourassa-Blanchette1,2, Marit M Biesheuvel3, John C Lam4
1Division of Infectious Diseases, Department of Medicine, Memorial University of Newfoundland, NL, Canada.
概括
针对候选血症的传染病咨询 (IDC) 改善了对最佳实践的遵守,并显著降低了患者的死亡率. 这种参与确保了更好的抗真菌治疗和指导方针一致性.
科学领域:
- 传染性疾病 传染性疾病
- 内部医学 内部医学
- 公共卫生 公共卫生
背景情况:
- 淋病症是一种严重的血液感染,具有显著的发病率和死亡率.
- 已建立的指导方针存在用于管理候选血症,但遵守和专家咨询的影响需要进一步澄清.
研究的目的:
- 评估传染病咨询 (IDC) 在为成年候选血病患者提供基于证据的建议方面所起的作用.
- 评估IDC与坚持 candidemia 管理最佳实践之间的关联.
- 确定IDC对患者结局,包括死亡率的影响.
主要方法:
- 2010年至2018年在加拿大进行的多中心回顾性队列研究.
- 包括被诊断患有候选血症的成年患者.
- 分析IDC与遵守建议之间的关联,如随访血培养,及时的抗真菌治疗,源控制和适当的治疗持续时间.
主要成果:
- 接受IDC治疗的患者不太可能没有抗真菌治疗 (4.8%对26%).
- 对复杂的候选血症的适当治疗持续时间在IDC中较高 (100%对47%).
- 在接受IDC的患者中,30天和60天的死亡率显著降低 (P <0.05).
结论:
- 传染病医生参与候选血病管理有助于加强对最佳实践指南的遵守.
- IDC与候选血病患者的死亡率大幅降低有关.
- 虽然遵守所有指导方针各不相同,但专家咨询在改善护理和结果方面发挥着至关重要的作用.
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