在接受质子抑制剂治疗的患者中,自发细菌性外周炎的改变病原体谱
Philip Kitchen1, Sarah L Schütte2, Tammo L Tergast2
1Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
质子抑制剂 (PPI) 治疗在肝硬化患者中显著改变了自发细菌性腹膜炎 (SBP) 病原体概况. PPI的使用与更多的グラム阳性细菌有关,包括Enterococcus spp.,影响抗生素选择.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 众所周知,用质子抑制剂 (PPI) 治疗可以改变肠道微生物群的组成.
- 这些肠道微生物群的变化可能会影响导致肝硬化患者自发细菌性腹膜炎 (SBP) 的病原体.
研究的目的:
- 调查PPI治疗对肝硬化患者SBP病原体的影响.
- 为了确定PPI使用是否与SBP细菌概况的特定变化有关.
主要方法:
- 分析了来自两个德国三级保健中心的227名肝硬化患者的培养阳性SBP病例.
- 在接受PPI治疗和未接受PPI治疗的患者之间的病原体谱的比较.
- 后勤回归分析,以确定SBP病原体概况的独立预测因素.
主要成果:
- 与非PPI组 (34.0%) 相比,PPI组 (62.1%) 的格拉姆阳性细菌的患病率明显高.
- 在PPI使用者中观察到Enterococcus spp.,Streptococcus spp.和Staphylococcus aureus的丰度增加.
- 格拉姆阴性细菌,特别是大肠杆菌,在非PPI组中更频繁 (64.0%与40.7%相比).
- 尽管调整了其他因素,但PPI的使用是格兰美阳性SBP的独立预测因素.
结论:
- 治疗PPI与SBP中显著增加的グラム阳性病原体有关,例如SBP中的Enterococcus spp.
- 这些发现突显了与PPI使用相关的SBP病原体谱的转变.
- 了解这种转变可以为肝硬化患者SBP的经验性抗生素治疗策略提供信息和指导.
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