尼特罗伊米达耐药性膜炎的流行病学和管理
Anna Boté-Casamitjana1, Rashmita Bodhani2, Peter L Chiodini1,3
1Hospital for Tropical Diseases, University College London Hospitals NHS Trust, London, UK.
耐尼胺醇耐火性巨病 (NRG) 很常见,特别是在难民儿童和前往印度的旅行者中. 使用阿尔本达,提尼达和美巴克林的逐步治疗方法在管理这些困难的感染方面显示出有效性.
科学领域:
- 热带医学 热带医学
- 传染性疾病 传染性疾病
- 寄生虫学的寄生虫学
背景情况:
- 是全球普遍存在的胃肠道原生动物病原体.
- 胺醇药物是标准的第一线治疗,但耐药性正在增加.
- 耐胺醇耐火性巨症 (NRG) 需要使用替代治疗策略.
研究的目的:
- 评估NRG在不同患者队列中的患病率.
- 评估实验室证明的耐火性巨病的逐步治疗阶梯的有效性.
- 为了确定与治疗失败相关的风险因素.
主要方法:
- 从2020-2024年对实验室和患者记录的回顾性审查.
- 包括通过显微镜或分子方法诊断出Giardia的成人和儿童.
- NRG的定义是治疗后至少两周的阳性分子测试.
主要成果:
- 发现了531例病例,59%的病例诊断在寻求庇护者/难民中 (A组).
- 在A组中,NRG的患病率为36.3%,儿童的失败率更高.
- 在未接受过治疗的旅行者 (B组) 中,NRG被发现在34.1%的旅行者中,印度旅行是显著的风险因素.
- 第二线 (阿尔本达/提尼达) 和第三线 (美巴克林) 疗法是有效的,耐受性良好.
结论:
- NRG在无症状和有症状的个体中普遍存在.
- 寻求庇护的儿童和前往印度的旅客是特别脆弱的人群.
- 目前的逐步治疗方案是有效的,但需要进一步研究耐药机制.
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