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唾液培养作为 ICU 环境中当前血液感染和抗菌药物耐药性的预测指标。

Saliva culture as a predictive indicator for current blood infections and antimicrobial resistance in the ICU setting.

机构信息

Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (ICT-UNESP), Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil.

Instituto Policlin de Ensino e Pesquisas-IPEP, Av. Nove de Julho, 430-Vila Ady'Anna, São José dos Campos, SP, 12243-001, Brazil.

出版信息

Sci Rep. 2023 Nov 20;13(1):20317. doi: 10.1038/s41598-023-47143-3.

Abstract

Antimicrobial resistance is a worldwide health problem and patients in intensive care are more vulnerable, requiring strict control measures and early identification. Currently, clinical culture materials are used to identify the bacterial agent, but saliva culture is not validated, which has great clinical relevance because it participates in several pathophysiological processes. The aim of this study was to validate saliva culture in an intensive care unit environment, determining its diagnostic value for infection. For this purpose, the results of the 39-month surveillance cultures, from the database of a private hospital were evaluated. A total of 323 cultures were paired between saliva, tracheal secretions, blood and urine from patients who were hospitalized for more than 5 days. The search for correlations between the results was performed using the Spearman correlation test. Severity and evolution data were also correlated. It was possible to correlate the presence of Klebsiella spp. between blood culture and saliva culture in 25% of the results (r = 0.01) and the correlation between saliva and tracheal secretion was 33% (r = 0.33447) with p < 0.0001. In conclusion, saliva can be an excellent discriminator of systemic infections, and can be considered a useful culture in clinical practice.

摘要

抗菌药物耐药性是一个全球性的健康问题,重症监护病房的患者更容易受到影响,需要采取严格的控制措施和早期识别。目前,临床培养物用于鉴定细菌病原体,但唾液培养尚未得到验证,这具有重要的临床相关性,因为它参与了几个病理生理过程。本研究旨在验证重症监护病房环境中的唾液培养,确定其对感染的诊断价值。为此,评估了一家私立医院数据库中 39 个月的监测培养物的结果。对住院时间超过 5 天的患者的唾液、气管分泌物、血液和尿液的 323 个培养物进行配对。使用 Spearman 相关检验来检测结果之间的相关性。还对严重程度和演变数据进行了相关性分析。可以在 25%的结果中(r=0.01)将血液培养物和唾液培养物中肺炎克雷伯菌属的存在进行相关性关联,并且唾液和气管分泌物之间的相关性为 33%(r=0.33447),p<0.0001。总之,唾液可以作为全身感染的良好鉴别物,可以考虑在临床实践中作为有用的培养物。

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