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短篇报告:选择性报告抗生素药敏试验对屎肠球菌血流感染患者抗生素使用的影响。

Short report: impact of selective reporting of antibiotic susceptibility testing on antibiotic use in patients with bloodstream infection with Enterococcus faecalis.

机构信息

Center for Pneumology, Donaustauf Hospital, Ludwigstraße 68, 93093, Donaustauf, Germany.

Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.

出版信息

Infection. 2023 Oct;51(5):1557-1562. doi: 10.1007/s15010-023-02045-4. Epub 2023 May 23.

DOI:10.1007/s15010-023-02045-4
PMID:37217812
Abstract

INTRODUCTION

Bloodstream infections with Enterococcus faecalis are associated with relevant morbidity and mortality. Targeted antimicrobial therapy is essential. The choice of an adequate treatment may be challenging when susceptibility testing offers different options. Selective reporting of antibiotic susceptibility test results might lead to a more tailored antibiotic therapy and could therefore be an important antimicrobial stewardship program intervention. The aim of this study was to analyse whether the introduction of selective reporting of antibiotic test results leads to a more targeted antibiotic therapy in patients with bloodstream infection with Enterococcus faecalis.

METHODS

This study was performed as a retrospective cohort study at the University Hospital Regensburg, Germany. All patients with blood cultures positive for Enterococcus faecalis between March 2003 and March 2022 were analysed. In February 2014 selective reporting of antibiotic susceptibility test results omitting sensitivity results for agents not recommended was introduced.

RESULTS

263 patients with blood cultures positive for Enterococcus faecalis were included. After introduction of selective reporting of antibiotic tests (AI) significantly more patients received ampicillin than before introduction of selective reporting (BI) (9.6% BI vs. 34.6% AI, p < 0.001).

CONCLUSION

Selective reporting of antibiotic susceptibility test results led to a significantly higher use of ampicillin.

摘要

简介

粪肠球菌引起的血流感染与相关发病率和死亡率有关。靶向抗菌治疗至关重要。当药敏试验提供不同的选择时,选择合适的治疗方法可能具有挑战性。选择性报告抗生素药敏试验结果可能会导致更有针对性的抗生素治疗,因此可能是重要的抗菌药物管理计划干预措施。本研究旨在分析选择性报告抗生素试验结果是否会导致粪肠球菌血流感染患者的抗生素治疗更有针对性。

方法

本研究是在德国雷根斯堡大学医院进行的回顾性队列研究。分析了 2003 年 3 月至 2022 年 3 月间血培养阳性的粪肠球菌患者。2014 年 2 月,引入了选择性报告抗生素药敏试验结果的方法,不报告不推荐使用的药物的药敏结果。

结果

共纳入 263 例血培养阳性的粪肠球菌患者。在引入选择性报告抗生素检测(AI)后,与引入前(BI)相比,接受氨苄西林治疗的患者明显增多(9.6% BI 与 34.6% AI,p<0.001)。

结论

选择性报告抗生素药敏试验结果显著增加了氨苄西林的使用。

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