重新思考日常生活:在感染性内心炎治疗完成后,是否需要重复血培养?
Jean Regina1, Nicoleta Ianculescu2, George Tzimas2
1Department of Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
概括
传染性内心炎 (IE) 治疗后的随访血液培养很少进行,并且经常错过复发. 这种诊断方法对于检测晚期IE复发的有用性有限.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
背景情况:
- 传染性内心炎 (IE) 是心脏内膜的严重感染.
- 治疗后IE的复发带来了重大的临床挑战.
- 对IE复发的有效监测策略至关重要.
研究的目的:
- 评估早期随访血液培养在检测感染性内心炎复发的有用性.
- 评估在完成IE抗微生物治疗后14天内获得的血液培养的诊断产量.
主要方法:
- 追溯分析598次感染性内心炎发作.
- 对抗微生物治疗完成后14天内进行的随访血液培养进行审查.
- 早期血液培养结果与后来的IE复发诊断结果的比较.
主要成果:
- 在598次IE发作中,只有135次 (23%) 在14天内进行了随访血液培养.
- 早期的血液培养检测到只有2 (1.5%) 的复发.
- 在治疗后15至120天间,共诊断出8例 (6%) 额外的IE复发,早期培养遗漏.
结论:
- 在IE治疗后的早期随访血液培养在检测复发时具有有限的效用.
- 目前依靠早期血液培养的策略不足以识别相当一部分IE复发.
- 需要采用替代或补充的监测策略,以便有效地对感染性内心炎进行治疗后监测.
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