直接血培养β -乳酸试验对脓毒症早期经验性抗生素治疗的改进

A. Mizrahi, F. Jauréguy, H. Petit, G. Péan de Ponfilly, E. Carbonnelle, A. Le Monnier, J. Zahar, B. Pilmis
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引用次数: 2

摘要

背景:多重耐药革兰氏阴性杆菌引起的脓毒症导致医生开广谱抗生素治疗,如碳青霉烯类。快速药敏试验有助于合理使用抗生素。本研究的目的是测量与快速报告β -乳酸试验(BLT)直接对革兰氏阴性杆菌阳性血培养相关的临床影响。方法:在一项观察性、多中心、前瞻性研究中,我们纳入了阳性血培养革兰氏染色观察到肠杆菌引起的脓毒症患者。血培养直接进行BLT和抗菌药敏试验(AST)。根据BLT对概率抗生素治疗进行修改的患者比例进行临床影响测量,包括接受碳青霉烯类药物治疗的患者。结果:纳入170例患者,其中44例(25.9%)患者经验性抗生素治疗不充分。根据BLT的结果,其中27个(15.9%)受益于早期的修改。在126例(74.1%)接受适当概率抗生素治疗的患者中,我们修改了其中28例(16.5%)的抗生素治疗,包括4/14例(28.5%)从碳青霉烯类降至第三代头孢菌素。结论:直接对血培养物进行BLT的实施使我们能够快速修改约三分之一肠杆菌引起的脓毒症患者的经验性抗生素治疗。
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Early Empirical Antibiotic Therapy Modification in Sepsis Using Beta-Lacta Test Directly on Blood Cultures
Background: Sepsis caused by multi-drug-resistant Gram-negative bacilli lead physicians to prescribe broad-spectrum antibiotic therapy, such as carbapenems. Rapid susceptibility testing can help with the rational use of antibiotics. The aim of this study was to measure the clinical impact associated with rapid reporting of Beta-Lacta test (BLT) directly on blood cultures positive with Gram-negative bacilli. Methods: In an observational, multicentric, prospective study, we included patients with sepsis caused by Enterobacterales observed on Gram staining of the positive blood cultures. BLT and antimicrobial susceptibility testing (AST) were performed directly on the blood cultures. Clinical impact was measured on the proportion of patients for whom the probabilistic antibiotic therapy was modified according to BLT, including patients receiving carbapenem. Results: 170 patients were included, of whom 44 (25.9%) were receiving inadequate empirical antibiotic therapy. Among them, 27 (15.9%) benefited from an early modification, according to the BLT results. Among 126 (74.1%) patients receiving appropriate probabilistic antibiotic therapy, we modified the antibiotic therapy for 28 (16.5%) of them, including 4/14 (28.5%) de-escalation from carbapenem to a third-generation cephalosporin. Conclusions: Implementation of BLT performed directly on blood cultures allowed us to rapidly modify the empirical antibiotic therapy for about one-third of patients with sepsis caused by Enterobacterales.
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来源期刊
Journal of International Translational Medicine
Journal of International Translational Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
自引率
0.00%
发文量
317
审稿时长
8 weeks
期刊介绍: Journal of International Translational Medicine (JITM, ISSN 2227-6394), founded in 2012, is an English academic journal published by Journal of International Translational Medicine Co., Ltd and sponsored by International Fderation of Translational Medicine. JITM is an open access journal freely serving to submit, review, publish, read and download full text and quote. JITM is a quarterly publication with the first issue published in March, 2013, and all articles published in English are compiled and edited by professional graphic designers according to the international compiling and editing standard. All members of the JITM Editorial Board are the famous international specialists in the field of translational medicine who come from twenty different countries and areas such as USA, Britain, France, Germany and so on.
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