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JACC:术前抗生素治疗时间对术后细菌培养结果的影响

2020-07-05 MedSci原创 MedSci原创

感染性心内膜炎(IE)心脏瓣膜切除术后细菌的培养会受术前抗生素治疗的影响。本研究旨在评估瓣膜培养结果(阳性瓣膜培养[PVC]与阴性瓣膜培养)对术前抗生素治疗的时间依赖性。

感染性心内膜炎(IE)心脏瓣膜切除术后细菌的培养会受术前抗生素治疗的影响。本研究旨在评估瓣膜培养结果(阳性瓣膜培养[PVC]与阴性瓣膜培养)对术前抗生素治疗的时间依赖性。

本研究纳入分析了231名IE患者(男性占81%,平均年龄62岁,66%患者为原生瓣膜),主要终点事件是PVC结果。其中25%为阳性瓣膜培养结果,75%是阴性瓣膜培养结果。对细菌种类、McCabe-Jackson分类和瓣膜类型进行多变量分析后,肠球菌属和葡萄球菌属PVC的优势比分别为6.35(95% [CI]:1.94-20.78;p=0.002)和3.93(95%CI:1.57-9.84;p=0.003)。另外,基于模型的PVC风险降低的优势比在第7天为0.64(95%CI:0.61-0.68),在第13天为0.74(95%CI:0.70-0.78),在第21天为0.98(95%CI:0.93-1.02)。

研究结果显示,在接受瓣膜手术治疗的感染性心内膜炎患者中,金黄色葡萄球菌和肠球菌与瓣膜培养生长有关。抗生素治疗7d后,术前抗生素治疗对瓣膜培养结果的额外影响较小,抗生素处理超过21天对培养结果无影响。

原始出处:

Valentin G et al.Duration of Pre-Operative Antibiotic Treatment and Culture Results in Patients With Infective Endocarditis.JACC.2020 July.

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    2020-10-27 hbwxf
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