基于唾液培养结果的呼吸道感染管理
Amir Jarjoui1, Malek Zaatreh2, Mohammad Abo Eid2
1Department of Internal Medicine, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Pulmonary Institute, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
概括
几乎三分之一的气管切除术患者只有敏感的生物体,但经验性抗生素治疗呼吸道感染在约三分之一的病例中是不适当的. 优化治疗策略对于这个患者群体至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 临界护理医学 临界护理医学
- 微生物学 微生物学
背景情况:
- 气管切除术在长期使用机械通风的患者中很常见.
- 气管切除管可以导致细菌生物膜的形成,导致气管炎或呼吸道感染 (RTIs).
- 病原体的分布和耐药性因临床环境,抗生素暴露和患者因素而异.
研究的目的:
- 为了分析气管切开术患者的唾液培养结果.
- 确定多耐药生物体 (MDROs) 的流行率和危险因素.
- 评估经验性抗生素治疗RTIs的适当性.
主要方法:
- 成人气管切除术患者的回顾性单中心研究 (2020-2024年).
- 从电子健康记录中提取的数据包括患者特征,唾液培养和RTI管理.
- 统计分析确定了与MDRO隔离相关的因素.
主要成果:
- 超过50%的患者有MDRO阳性唾液培养;30%只有敏感生物.
- 较高的并发症指数,更长的住院时间和先前的抗生素暴露与MDROs有关.
- 常见的病原体包括肠杆菌,伪菌,青杆菌,金黄色葡萄球菌.
结论:
- 气管切除术患者中很大一部分患有易受感染的生物体,这对经验治疗构成了挑战.
- 大约三分之一的RTI发作接受了不适当的经验性抗生素治疗.
- 局部抗生素图,MDRO风险分层和改善的培养质量可以提高经验治疗的准确性.
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