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新冠疫情对一家三级护理医院血流感染管理的影响

Impact of the COVID-19 Pandemic on the Management of Bloodstream Infections in a Tertiary Care Hospital.

作者信息

Böing Christian W, Froböse Neele J, Schaumburg Frieder, Kampmeier Stefanie

机构信息

Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, 48149 Münster, Germany.

Institute of Medical Microbiology, Domagkstraße 10, 48149 Münster, Germany.

出版信息

Pathogens. 2023 Apr 18;12(4):611. doi: 10.3390/pathogens12040611.

Abstract

bacteremia (SAB) is associated with a high mortality rate. The clinical outcome of SAB patients highly depends on early diagnosis, adequate antibiotic therapy and source control. In the context of the COVID-19 pandemic, the health care system faced additional organizational challenges and the question arose whether structured screening and triaging for COVID-19 and shifting resources influence the management of SAB. Patients ( = 115) with SAB were enrolled in a retrospective comparative study with historical controls (March 2019-February 2021). The quality of SAB therapy was assessed with a point score, which included correct choice of antibiotic, adequate dosage of antibiotic, sufficient duration of therapy, early start of therapy after receipt of findings, focus search and taking control blood cultures 3-4 days after starting adequate antibiotic therapy. The quality of treatment before and after the onset of the COVID-19 pandemic were compared. No significant differences in the total score points were found between the pre-COVID-19 and COVID-19 cohort. All quality indicators, except the correct duration of antibiotic therapy, showed no significant differences in both cohorts. Furthermore, there were no significant differences in the outcome between both cohorts. The treatment quality of SAB therapy was comparable before and during the COVID-19 pandemic.

摘要

血流感染(SAB)与高死亡率相关。SAB患者的临床结局高度依赖于早期诊断、充分的抗生素治疗和源头控制。在新冠疫情背景下,医疗保健系统面临额外的组织挑战,于是出现了一个问题,即针对新冠病毒的结构化筛查和分诊以及资源转移是否会影响SAB的管理。对115例SAB患者进行了一项与历史对照的回顾性比较研究(2019年3月至2021年2月)。采用评分系统评估SAB治疗质量,评分包括抗生素的正确选择、抗生素的适当剂量、足够的治疗持续时间、收到检查结果后尽早开始治疗、病灶查找以及在开始充分抗生素治疗3 - 4天后采集对照血培养。比较了新冠疫情爆发前后的治疗质量。在新冠疫情前和新冠疫情队列之间,总分没有发现显著差异。除抗生素治疗的正确持续时间外,所有质量指标在两个队列中均无显著差异。此外,两个队列的结局也没有显著差异。在新冠疫情之前和期间,SAB治疗的质量具有可比性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aa4/10143185/a12a3eb4ae1a/pathogens-12-00611-g001.jpg

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