广谱抗生素使用模式与重症患者的侵袭性候群病的相关性以及早期预测模型的开发
Gang Chen1,2,3,4, Wen Li1,2,3,4, Yuhao Zhao1,2,3,4
1Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Xiangya Road No 87, Kaifu District, Changsha, 410008, Hunan, People's Republic of China.
Scientific reports
|November 7, 2025
概括
广谱抗生素的使用,持续时间和组合疗法显著增加了侵袭性 кандидоз (IC) 的风险. 一个新的诺莫格拉姆模型准确地预测了接受广谱抗生素的患者的IC风险.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 侵袭性候群病 (IC) 是一种严重的ICU感染,死亡率高,通常与广泛的抗生素使用有关.
- 了解与IC相关的特定抗生素概况对于风险分层和预防至关重要.
研究的目的:
- 调查细节抗生素使用模式与ICU患者的IC发生之间的关联.
- 开发和验证用广谱抗生素治疗的患者中IC的预测模型.
主要方法:
- 对1260名接受广谱抗生素治疗的患者和877名对照患者的临床数据的回顾性分析.
- 倾向性得分匹配 (PSM) 和治疗权重的逆概率 (IPTW) 调整风险因素.
- 使用后勤回归开发IC风险名录,通过AUC,DCA和CIC进行验证.
主要成果:
- 广谱抗生素是IC的独立风险因素.
- 脂,糖,和oxazolidinones增加了单一治疗中的IC风险;组合治疗 (OR=2.341) 显著增加了风险.
- 开发的诺米图,包括吸烟,败血症,CRRT,PNI,β-乳糖胺/β-乳糖酶抑制剂和BDG,显示出强大的预测性能 (AUC 0.863训练,0.784验证).
结论:
- 特定的抗生素类型,持续时间和组合与侵袭性 кандидоз有显著的关联.
- 这种新型的诺米图谱为预测接受广谱抗生素的ICU患者的IC风险提供了宝贵的工具,有助于临床决策.
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