在多药耐药格拉姆阴性药物时代的外科手术预防
Christian Eckmann1, Nana-Maria Wagner2
1Department of General, Visceral and Thoracic Surgery, Academic Hospital of Goettingen University, Klinikum Hannoversch-Muenden.
针对性周周手术抗生素预防 (PAP) 在腹部手术患者的手术部位感染 (SSIs) 显著降低,这些患者被多抗药性阴性细菌 (MDR-GN) 殖民. 根据风险调整的查和有针对性的PAP是改善结果的关键.
科学领域:
- 传染性疾病 传染性疾病
- 手术瘤学手术瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 手术部位感染 (SSI) 是腹部手术后发病和死亡的主要原因.
- 在全球范围内,患有多抗药性阴性细菌 (MDR-GN) 的患者的患病率正在增加.
- 术后抗生素预防 (PAP) 对于降低SSI率至关重要.
研究的目的:
- 审查当前关于静脉直周手术抗生素预防 (PAP) 的知识.
- 讨论最近在管理MDR-GN殖民患者进行腹部手术的进展.
- 突出在这个高风险人群中预防SSI的战略.
主要方法:
- 对MDR-GN殖民患者PAP的当前文献和最新证据的审查.
- 对查和有针对性的预防策略的有效性进行分析.
- 评估非殖民化程序和抗生素选择.
主要成果:
- 风险适应查与向PAP相结合,可以在接受选择性腹部手术的MDR-GN殖民患者中显著降低SSI率.
- 目前的手术前去殖民化程序没有证明其有效性.
- 在已被证明的MDR-GN殖民的情况下,有针对性的预防在减少术后SSI方面是有效的.
结论:
- 向预防在经过腹部手术的患者中有效减少术后的SSI,这些患者已经证明了MDR-GN殖民.
- 需要进一步的研究来优化对MDR-GN殖民地的查,并完善针对性预防策略.
- 对抗卡巴耐药细菌的创新脱殖方法和特定抗生素的研究是必不可少的.
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