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本文引用的文献

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Is EMA warning on quinolones and fluoroquinolones really assessed? An EudraVigilance database analysis.喹诺酮类和氟喹诺酮类药物的 EMA 警告真的被评估了吗?一项 EudraVigilance 数据库分析。
Minerva Urol Nephrol. 2023 Jun;75(3):374-380. doi: 10.23736/S2724-6051.23.05169-8. Epub 2023 Mar 20.
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Rational use of the fluoroquinolones.氟喹诺酮类药物的合理使用。
S Afr Med J. 2019 May 31;109(6):378-381. doi: 10.7196/SAMJ.2019.v109i6.14002.
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Carbapenem versus Cefepime or Piperacillin-Tazobactam for Empiric Treatment of Bacteremia Due to Extended-Spectrum-β-Lactamase-Producing in Patients with Hematologic Malignancy.碳青霉烯类药物与头孢吡肟或哌拉西林他唑巴坦治疗血液恶性肿瘤患者产超广谱β-内酰胺酶菌血症的经验性治疗。
Antimicrob Agents Chemother. 2019 Jan 29;63(2). doi: 10.1128/AAC.01813-18. Print 2019 Feb.
4
Early and rapid prediction of postoperative infections following percutaneous nephrolithotomy in patients with complex kidney stones.经皮肾镜碎石取石术后复杂肾结石患者术后感染的早期快速预测。
BJU Int. 2019 Jun;123(6):1041-1047. doi: 10.1111/bju.14484. Epub 2018 Aug 9.
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Ceftriaxone treatment of complicated urinary tract infections as a risk factor for enterococcal re-infection and prolonged hospitalization: A 6-year retrospective study.头孢曲松治疗复杂性尿路感染与肠球菌再感染及住院时间延长的关系:一项 6 年回顾性研究。
Bosn J Basic Med Sci. 2018 Nov 7;18(4):361-366. doi: 10.17305/bjbms.2018.3544.
6
Antimicrobial susceptibility patterns of escherichia coli in children and adults with urinary tract infections.儿童和成人尿路感染患者中大肠杆菌的抗菌药敏模式
Wiad Lek. 2018;71(2 pt 1):306-310.
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Risk factors for fever and sepsis after percutaneous nephrolithotomy.经皮肾镜取石术后发热和脓毒症的危险因素。
Asian J Urol. 2016 Apr;3(2):82-87. doi: 10.1016/j.ajur.2016.03.001. Epub 2016 Mar 11.
8
Incidence of Extended-Spectrum β-Lactamase (ESBL)-Producing Escherichia coli and Klebsiella Infections in the United States: A Systematic Literature Review.美国产超广谱β-内酰胺酶(ESBL)的大肠杆菌和克雷伯菌感染的发生率:系统文献回顾。
Infect Control Hosp Epidemiol. 2017 Oct;38(10):1209-1215. doi: 10.1017/ice.2017.156. Epub 2017 Jul 31.
9
Randomized controlled trial of piperacillin-tazobactam, cefepime and ertapenem for the treatment of urinary tract infection caused by extended-spectrum beta-lactamase-producing Escherichia coli.哌拉西林-他唑巴坦、头孢吡肟和厄他培南治疗产超广谱β-内酰胺酶大肠埃希菌所致尿路感染的随机对照试验
BMC Infect Dis. 2017 Jun 7;17(1):404. doi: 10.1186/s12879-017-2502-x.
10
Mortality Due to Nosocomial Infection with Klebsiella pneumoniae ESBL<sup/>.产超广谱β-内酰胺酶肺炎克雷伯菌所致医院感染的死亡率
Adv Exp Med Biol. 2017;1022:19-26. doi: 10.1007/5584_2017_38.

围手术期早期使用碳青霉烯类药物治疗产 ESBL 大肠埃希菌所致尿石症的作用。

The role of early use of Carbapenems perioperatively for urolithiasis with ESBL-producing Escherichia coli.

机构信息

Department of Urology, Foshan Women and Children Hospital, Foshan, Guangdong, China.

Department of Urology, Jiangmen Central Hospital, Jiangmen, Guangdong, China.

出版信息

BMC Urol. 2024 Sep 6;24(1):195. doi: 10.1186/s12894-024-01572-y.

DOI:10.1186/s12894-024-01572-y
PMID:39242526
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11378573/
Abstract

BACKGROUND

Urolithiasis combined with ESBL-producing E. coli is often difficult to control and leads to higher postoperative infection-related complications. This study was aim to explore the efficacy and necessity for early use of carbapenem antibiotics perioperatively in urolithiasis patients with urinary tract infections caused by ESBL-producing E. coli.

METHODS

The study included a total of 626 patients who were separated into two groups: Group I (the ESBL-producing E. coli group) and Group II (the non-ESBL-producing E. coli group). Antibiotic susceptibility testing was performed and the two groups induced postoperative infection-related events were recorded. the efficacy of perioperative antibiotics was evaluated.

RESULTS

All strains of E. coli in our research were sensitive to Carbapenems antibiotics. In addition to Carbapenems, the resistance rates of ESBL-producing E. coli to 6 other commonly used antibiotics were higher than those of non-ESBL-producing strains. Based on the preoperative antibiotic susceptibility test for the ESBL-producing E. coli group and the qSOFA score, the Carbapenems were more effective than the β-lactamase inhibitors (p = 0.08), while for the non-ESBL-producing E. coli group, there was no difference in the treatment effects between Carbapenems, β-lactamase inhibitors, Ceftazidime and Quinolones (p = 0.975).

CONCLUSIONS

Carbapenem antibiotics significantly reduced the incidence of postoperative infection-related events compared with other types of antibiotics for ESBL-producing E. coli infections in patient with urolithiasis.

摘要

背景

结石合并产 ESBL 大肠埃希菌感染往往难以控制,导致术后感染相关并发症较高。本研究旨在探讨产 ESBL 大肠埃希菌尿路感染患者围手术期早期使用碳青霉烯类抗生素的疗效和必要性。

方法

本研究共纳入 626 例患者,分为两组:Ⅰ组(产 ESBL 大肠埃希菌组)和Ⅱ组(非产 ESBL 大肠埃希菌组)。进行抗生素药敏试验,记录两组术后感染相关事件,评估围手术期抗生素的疗效。

结果

本研究中所有大肠埃希菌菌株均对碳青霉烯类抗生素敏感。除碳青霉烯类外,产 ESBL 大肠埃希菌对其他 6 种常用抗生素的耐药率高于非产 ESBL 株。根据产 ESBL 大肠埃希菌组的术前抗生素药敏试验和 qSOFA 评分,碳青霉烯类抗生素的疗效优于β-内酰胺酶抑制剂(p=0.08),而非产 ESBL 大肠埃希菌组,碳青霉烯类、β-内酰胺酶抑制剂、头孢他啶和喹诺酮类抗生素的治疗效果无差异(p=0.975)。

结论

与其他类型的抗生素相比,碳青霉烯类抗生素可显著降低结石合并产 ESBL 大肠埃希菌感染患者术后感染相关事件的发生率。