多微生物和单微生物革兰氏阴性菌血流感染的影像学检查的诊断和治疗效果 - 一项回顾性队列研究。
Diagnostic and therapeutic yield of imaging studies in Polymicrobial and Monomicrobial Gram-negative bloodstream infections - a retrospective cohort study.
机构信息
Department of Internal Medicine C, Hillel-Yaffe Medical Center, Hadera, Israel.
Infectious Diseases Unit, Hillel-Yaffe Medical Center, Hadera, Israel.
出版信息
Diagn Microbiol Infect Dis. 2024 Sep;110(1):116366. doi: 10.1016/j.diagmicrobio.2024.116366. Epub 2024 May 19.
PURPOSE
Appropriate antimicrobial therapy and surgical drainage, improve survival in patients with Gram negative bloodstream infections (BSI). Data about the yield of imaging studies in polymicrobial BSI is sparse. The aim of the study was to assess the need for imaging studies and surgical drainage among patients with polymicrobial compared to monomicrobial BSI.
RESULTS
In a retrospective cohort study of adult patients with Gram negative BSI, 135 patients with monomicrobial BSI were compared to 82 with polymicrobial BSI. Imaging studies were performed in 56.3 % of patients with monomicrobial BSI and in 50 % of polymicrobial BSI (p=0.4), surgical drainage was performed in 20.1 % of patients with monomicrobial BSI and 27.2 % of polymicrobial BSI (p=0.25). Surgical drainage was performed in 26.2 % of patients who survived vs. 11.8 % of patients who died (p=0.035).
CONCLUSIONS
There is no difference in the diagnostic approach to monomicrobial and polymicrobial Gram-negative BSI. Surgical drainage is associated with decreased mortality.
目的
适当的抗菌治疗和外科引流可以提高革兰氏阴性菌血流感染（BSI）患者的生存率。关于混合菌 BSI 影像学研究结果的资料很少。本研究旨在评估与单一致病菌 BSI 相比，混合菌 BSI 患者是否需要影像学研究和外科引流。
结果
在一项成人革兰氏阴性菌 BSI 的回顾性队列研究中，将 135 例单一致病菌 BSI 患者与 82 例混合菌 BSI 患者进行比较。56.3%的单一致病菌 BSI 患者和 50%的混合菌 BSI 患者进行了影像学检查（p=0.4），20.1%的单一致病菌 BSI 患者和 27.2%的混合菌 BSI 患者进行了外科引流（p=0.25）。在存活的患者中，有 26.2%的患者进行了外科引流，而在死亡的患者中，有 11.8%的患者进行了外科引流（p=0.035）。
结论
单一致病菌和混合菌革兰氏阴性菌 BSI 的诊断方法没有差异。外科引流与降低死亡率相关。
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