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Eur Respir J:胸膜感染成年的微生物学分析

2019-10-06 xing.T MedSci原创

由此可见,在胸膜感染患者中,感染的地理位置和感染环境与预期的致病微生物有很大关系。这些结果应该反映在经验性抗菌治疗的选择上。

胸膜感染是成人发病和死亡的主要原因。鉴定入侵的微生物是选择适当抗菌治疗的关键。胸膜感染的微生物学谱在时间或地理上是否可变尚不明确。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,该系统综述旨在调查现有文献,以了解全球微生物学谱以及可能影响该模式的因素。


研究人员检索了2000年至2018年间Ovid MEDLINE和Embase数据库,以查找报道了胸膜感染成人微生物学的出版文献。观察性研究和干预性研究均包括在内。如果报告的主要重点是儿科人群、结核性脓胸或术后脓胸,则将研究排除在外。研究人员将受试者超过20名,且明确分离出微生物菌株的研究纳入进行分析。从所包括的研究中整理出每个特定微生物/组的分离株数量。除了整体就诊数据外,还按地理分布、感染环境(社区与医院)和报告时间进行了亚组分析。


研究人员最初检索得到20980份研究报告,其中75篇报告了10241例患者数据的研究被纳入进行数据合成。世界范围内报告的最常见的微生物是金黄色葡萄球菌。在地理上,肺炎球菌和绿脓杆菌链球菌分别是热带和温带地区最常见的分离株。社区和医院获得性感染之间的微生物学模式差异很大,据报道医院获得性感染中革兰氏阴性和耐药菌的分离率更高。该系统评价的主要局限性是某些细菌报告方法的异质性,以及欧洲和东南亚地区报告的优势。


由此可见,在胸膜感染患者中,感染的地理位置和感染环境与预期的致病微生物有很大关系。这些结果应该反映在经验性抗菌治疗的选择上。

 

原始出处:


Maged Hassan,et al.The microbiology of pleural infection in adults: a systematic review.Eur Respir J.2019.https://erj.ersjournals.com/content/54/3/1900542


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    2020-05-30 lifestar
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