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Clin Infect Dis:导尿管相关尿路感染别用经验抗菌治疗了

2017-12-26 梁舒瑶 环球医学

2017年发表在《Clin Infect Dis》的一项由以色列科学家进行的前瞻性队列研究表明,经验抗菌治疗不改善导尿管相关尿路感染(CAUTI)。

2017年发表在《Clin Infect Dis》的一项由以色列科学家进行的前瞻性队列研究表明,经验抗菌治疗不改善导尿管相关尿路感染(CAUTI)。

背景:CAUTI是最常见的健康治疗相关获得性感染。研究者旨在描述CAUTI患者短期和长期生存,以及经验抗菌治疗对生存率的影响。

方法:在这项前瞻性、观察性研究中,研究者纳入因慢性留置导管相关UTI和脓毒症入住医疗部的连续成人患者。主要结局为30天全因死亡率和随访结束时的长期生存率。使用logistic回归和Cox比例风险模型进行多变量分析,以确定不良结局的独立风险因素。构建接受恰当经验抗菌治疗的倾向评分模型,并用于匹配患者。

结果:共纳入315例CAUTI连续患者。该队列由老年人和高龄患者(平均年龄79.2±11.5)组成。粗略30天全因死亡率为30.8%(97/315)。中位生存时间为82天(四分位间距[IQR] 22~638)。恰当的早期经验治疗与30天死亡率无显着统计学相关性,倾向评分匹配比值比(OR)1.39(0.76~2.55)。相似的,在倾向匹配队列中,恰当的经验治疗与长期生存率无显着统计学相关性(风险比[HR]=0.99,95%置信区间[CI] 0.75~1.3)。

结论:在本研究中,不考虑恰当的经验抗菌治疗,CAUTI患者的短期和长期预后较差。避免经验抗菌药物用于CAUTI或是医院一项重要的抗菌药管理干预。

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1956946, encodeId=e95a19569467f, content=<a href='/topic/show?id=6c1f55e02b3' target=_blank style='color:#2F92EE;'>#抗菌治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55702, encryptionId=6c1f55e02b3, topicName=抗菌治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKJUlpK5asKgfVAGEUnO6CbNf6icCfycdBO2zX5TWJq27yt434nFicdjf7OsvbOZBOotQdNx6J6PaZQ/132, createdBy=fcba2500108, createdName=ms6519009802973839, createdTime=Wed Oct 24 00:01:00 CST 2018, time=2018-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012535, encodeId=8a102012535cf, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Mon Dec 10 08:01:00 CST 2018, time=2018-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330639, encodeId=9d3b13306391f, content=<a href='/topic/show?id=c6b455688d1' target=_blank style='color:#2F92EE;'>#抗菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55688, encryptionId=c6b455688d1, topicName=抗菌)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/2898B09F0DA89357D0D54A725E611AC7/100, createdBy=fdd32500040, createdName=ms7899726347904398, createdTime=Thu Dec 28 11:01:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545600, encodeId=f2be154560020, content=<a href='/topic/show?id=3afb466990c' target=_blank style='color:#2F92EE;'>#导尿管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46699, encryptionId=3afb466990c, topicName=导尿管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e39a13780945, createdName=12498b3em12(暂无昵称), createdTime=Thu Dec 28 11:01:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=272731, encodeId=5bd32e2731a5, content=谢谢分享.学习受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Tue Dec 26 20:19:01 CST 2017, time=2017-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=272724, encodeId=b7c92e2724cd, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Tue Dec 26 20:07:55 CST 2017, time=2017-12-26, status=1, ipAttribution=)]
    2017-12-26 清风拂面

    谢谢分享.学习受益匪浅

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1956946, encodeId=e95a19569467f, content=<a href='/topic/show?id=6c1f55e02b3' target=_blank style='color:#2F92EE;'>#抗菌治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55702, encryptionId=6c1f55e02b3, topicName=抗菌治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKJUlpK5asKgfVAGEUnO6CbNf6icCfycdBO2zX5TWJq27yt434nFicdjf7OsvbOZBOotQdNx6J6PaZQ/132, createdBy=fcba2500108, createdName=ms6519009802973839, createdTime=Wed Oct 24 00:01:00 CST 2018, time=2018-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012535, encodeId=8a102012535cf, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Mon Dec 10 08:01:00 CST 2018, time=2018-12-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1330639, encodeId=9d3b13306391f, content=<a href='/topic/show?id=c6b455688d1' target=_blank style='color:#2F92EE;'>#抗菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55688, encryptionId=c6b455688d1, topicName=抗菌)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/2898B09F0DA89357D0D54A725E611AC7/100, createdBy=fdd32500040, createdName=ms7899726347904398, createdTime=Thu Dec 28 11:01:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545600, encodeId=f2be154560020, content=<a href='/topic/show?id=3afb466990c' target=_blank style='color:#2F92EE;'>#导尿管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46699, encryptionId=3afb466990c, topicName=导尿管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e39a13780945, createdName=12498b3em12(暂无昵称), createdTime=Thu Dec 28 11:01:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=272731, encodeId=5bd32e2731a5, content=谢谢分享.学习受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Tue Dec 26 20:19:01 CST 2017, time=2017-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=272724, encodeId=b7c92e2724cd, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Tue Dec 26 20:07:55 CST 2017, time=2017-12-26, status=1, ipAttribution=)]
    2017-12-26 清风拂面

    谢谢分享.学习了

    0

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