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管理感染性疾病科的成年患者:国际 ID-IRI 研究。

Managing adult patients with infectious diseases in emergency departments: international ID-IRI study.

机构信息

ID-IRI, Ankara, Turkey.

Institute for Infection and Immunity, St George's University of London, London, UK.

出版信息

J Chemother. 2021 Sep;33(5):302-318. doi: 10.1080/1120009X.2020.1863696. Epub 2021 Mar 18.

Abstract

We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 ± 0.74. Sepsis (qSOFA ≥ 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 ± 0.963) compared to upper-middle (0.17 ± 0.482) and high-income (0.36 ± 0.714) countries (). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory ( = 877, 43.3%), lower-respiratory ( = 316, 16.1%), and lower-urinary ( = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors ( = 307, 15.7%), third-generation cephalosporins ( = 251, 12.8%), and quinolones ( = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.

摘要

我们旨在探索优化急诊科抗菌治疗的因素。2020 年 1 月 18 日,在 22 个国家的 53 家转诊/三级医院进行了为期一天的患病率调查。在到急诊科就诊的 11557 名患者中,有 1957 名(17%)患有感染。qSOFA 平均得分为 0.37±0.74。记录到 218 名(11.1%)患者存在脓毒症(qSOFA≥2)。中低收入国家(1.48±0.963)的 qSOFA 评分明显高于中上收入国家(0.17±0.482)和高收入国家(0.36±0.714)()。8 名(3.7%)脓毒症患者接受了门诊治疗。最常见的诊断是上呼吸道感染(877 例,43.3%)、下呼吸道感染(316 例,16.1%)和下尿路感染(201 例,10.3%)。1085 名(55.4%)患者接受了抗生素治疗。最常用的抗生素是β-内酰胺(BL)和 BL 抑制剂(307 例,15.7%)、第三代头孢菌素(251 例,12.8%)和喹诺酮类(204 例,10.5%)。抗生素的使用可能存在不合理和不适当的住院决策。资源有限的国家患者的脓毒症更为严重。因此,需要更好的组织方案。

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