逆转抗微生物耐药性 (AMR) 在血学中,在瘤学患者中,在阴性病原体中
Nitin Bansal1, Neelam Sachdeva2, Dinesh Bhurani3
1Infectious Diseases, Rajiv Gandhi Cancer Institute, Sir Chotu Ram Marg, Rohini, Sector 5, New Delhi, 110085 India.
概括
抗微生物药物管理 (AMS) 活动显著降低了发烧性中性病症的血液瘤病患者中,格拉姆阴性细菌 (GNB) 的耐药性. 这表明,在脆弱人群中有效地减少了耐药性.
科学领域:
- 传染性疾病 传染性疾病
- 血液学-瘤学 血液学-瘤学
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 血液瘤学患者的发烧性中性质疏松症具有高格兰阴性细菌 (GNB) 感染的高风险.
- 在这种免疫受损人群中,GNB的药物敏感性模式 (DSP) 对有效治疗至关重要.
- 抗微生物管理 (AMS) 计划对于管理抗微生物耐药性 (AMR) 是必不可少的.
研究的目的:
- 分析发烧性中性衰竭的血液瘤学患者GNB的DSP趋势.
- 评估AMS活动对GNB阻力模式的影响.
- 评估与GNB bacteremia相关的临床结果和死亡率.
主要方法:
- 追溯研究分析了从2019年4月到2024年4月的数据.
- 涉及535名患者,其中601例GNB细菌病发作.
- 对DSP和临床参数的时间序列分析 (CCI,SOFA,Pitts得分,死亡率).
主要成果:
- 在Klebsiella pneumoniae (90.3%至48.1%) 和大肠杆菌 (54.5%至27.7%) 中,卡巴胺耐药性下降.
- 在Pseudomonas aeruginosa中,难以治疗 (DTR) 率从83.3%降至10%.
- AMS的干预措施包括抗生素限制,戒烟方案,传染病医生的参与以及诊断改进.
结论:
- AMS活动可以有效地减少GNB耐药性,即使在脆弱的血液瘤患者中也是如此.
- 实施全面的AMS战略对于打击AMR至关重要.
- 持续监测DSP对于调整治疗指南至关重要.
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