在格拉姆阴性血液感染中错过抗生素降级机会的分析
Mahir Kapmaz1, Şiran Keske2,3, Süda Tekin4
1Department of Infectious Diseases and Clinical Microbiology, International School of Medicine, Istanbul Medipol University, 34815 Istanbul, Turkey.
Antibiotics (Basel, Switzerland)
|August 28, 2025
概括
对于格拉姆阴性血流感染的抗生素降级 (ADE) 经常被遗漏,特别是在ESBL或血液恶性瘤中. 优化ADE需要解决医生的犹和改善管理计划.
科学领域:
- 传染性疾病
- 抗菌药物管理
- 临床微生物学
背景情况:
- 抗生素降级 (ADE) 对于优化治疗和打击抗生素耐药性至关重要.
- 在临床实践中,被称为"错失机会"的ADE表现不佳是令人担忧的.
- 高抗微生物耐药性需要对ADE实践进行仔细分析.
研究的目的:
- 分析抗生素降级 (ADE) 错过的机会在格拉姆阴性血流感染 (BSI).
- 在高抗微生物耐药性环境下识别与错过的ADE机会相关的因素.
- 评估错过的ADE对患者结果的影响.
主要方法:
- 一个回顾性,双中心的队列研究.
- 从2018年1月到2019年6月的成年BSI患者的包括.
- 对ADE发作,错失机会和30天死亡率的分析.
主要成果:
- 在273个BSI中,101个 (36.9%) 是错过的ADE机会.
- 在患有血性恶性瘤 (OR=4. 4) 和ESBL感染 (OR=6. 2) 的患者中,错过的ADE机会显著增加.
- 埃尔塔胺的使用和大肠杆菌BSI的存在与较少的遗漏ADE机会有关.
结论:
- 产生ESBL的生物和血液恶性瘤是适当的ADE的重要障碍.
- 医生犹是一个关键的挑战, 抗菌管理计划必须解决.
- 需要有针对性的干预措施来提高ADE率并优化患者护理.
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