摘要
背景:医院感染在自发性蛛网膜下腔出血(SAH)患者中很常见。这项回顾性队列研究的目的是确定SAH期间感染的发生率,并评估炎症参数的过程及其对长期预后的影响。 目的:纳入九十九名连续盘卷的SAH患者。实验室和临床参数以及培养阳性感染均遵循疾病进展。 Glasgow结果评分(GOS)评估6个月,有利(GOS> 3)和不良结局(GOS≤3)两项评估。 结果:最常见的感染是肺(30.3%)尿路(25.3%),血流感染(20.2%)和脑室炎(5.1%)。感染的发生率在结局组之间没有显着差异。相比之下,不良结局的患者脓毒症发病率较高(46.7%,而24.6%)。 C反应蛋白(CRP)和白细胞显着高于不良结局患者。 SAH后头3天的CRP增加6 mg / dl或更高,与不良结局独立相关(OR 7.19 CI 1.7-30.52; p = 0.008)。早期CRP增加的患者在入院后的前3天更经常用抗菌治疗治疗,导致后期培养阳性感染的发生率显着降低。 结论:SAH急性期CRP急剧上升可能有助于早期发现神经系统发病高风险患者的集结。早期的抗微生物治疗降低了在疾病过程中显示培养阳性感染的患者的发生率。
关键词: 炎症,结局,感染,C反应蛋白,蛛网膜下腔出血,神经炎症。
图形摘要
Current Drug Targets
Title:Nosocomial Infections and Antimicrobial Treatment in Coiled Patients with Aneurysmal Subarachnoid Hemorrhage
Volume: 18 Issue: 12
关键词: 炎症,结局,感染,C反应蛋白,蛛网膜下腔出血,神经炎症。
摘要: Background: Nosocomial infections are common in patients with spontaneous subarachnoid hemorrhage (SAH). The aim of this retrospective cohort study was to determine the incidence of infections during SAH and to evaluate the course of inflammation parameters and its implications for long term outcome.
Objective: Ninety-nine consecutive coiled SAH patients were included. Laboratory and clinical parameters as well as culture positive infections were followed over the disease course. Long-term outcome was assessed at 6-month by the Glasgow Outcome score (GOS) and dichotomized in favorable (GOS>3) and unfavorable outcome (GOS≤3). Results: The most frequent infections were pulmonary (30.3%) urinary tract (25.3%), blood stream infections (20.2%) and ventriculitis (5.1%). The incidence of infections did not significantly differ between outcome groups. In contrast, patients with unfavorable outcome had a higher incidence of sepsis (46.7% versus 24.6%). C-reactive protein (CRP) and leukocytes were significantly higher in patients with unfavorable outcome. A CRP increase of 6 mg/dl or more in the first 3 days after SAH was independently associated with unfavorable outcome (OR 7.19 CI 1.7-30.52; p=0.008). Patients with an early CRP increase were more frequently treated with antimicrobial therapy in the first 3 days after admission which led to a significantly lower incidence of culture positive infections in the later course. Conclusion: A sharp CRP-increase in the acute phase of SAH could potentially aid the intensivist in the early identification of patients at high risk for neurological morbidity. Early antimicrobial treatment reduces the rate of patients showing culture positive infections in the course of the disease.Export Options
About this article
Cite this article as:
Nosocomial Infections and Antimicrobial Treatment in Coiled Patients with Aneurysmal Subarachnoid Hemorrhage, Current Drug Targets 2017; 18 (12) . https://dx.doi.org/10.2174/1389450117666160401124426
DOI https://dx.doi.org/10.2174/1389450117666160401124426 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
Related Journals
Related Books
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Diabetic Retinopathy: Current and New Treatment Options
Current Diabetes Reviews Invasive Aspergillosis in Children and Adolescents
Current Pharmaceutical Design Use of Diffusion-Weighted Magnetic Resonance Imaging and Apparent Diffusion Coefficient in Gastric Cancer Staging
Current Medical Imaging Continuous Elevation of Intracellular Ca2+ Is Essential for the Development of Cerebral Vasospasm
Current Vascular Pharmacology Extracts and Flavonoids of <i>Passiflora</i> Species as Promising Anti-inflammatory and Antioxidant Substances
Current Pharmaceutical Design Extending Life Using Tissue and Organ Replacement
Current Aging Science Glucocorticoids and the Cardiovascular System: State of the Art
Current Pharmaceutical Design Cholinesterase Inhibitors Slow Decline in Executive Functions, Rather than Memory, in Alzheimers Disease: A 1-Year Observational Study in the Sunnybrook Dementia Cohort
Current Alzheimer Research Lithium and its Neuroprotective and Neurotrophic Effects: Potential Treatment for Post-Ischemic Stroke Sequelae
Current Drug Targets Molecular Evidence of Cryptotanshinone for Treatment and Prevention of Human Cancer
Anti-Cancer Agents in Medicinal Chemistry Matrix Metalloproteinases
Current Medicinal Chemistry Boosting Interleukin-10 Production: Therapeutic Effects and Mechanisms
Current Drug Targets - Immune, Endocrine & Metabolic Disorders The Role of Autophagy in Subarachnoid Hemorrhage: An Update
Current Neuropharmacology Anesthetic Considerations for Electroconvulsive Therapy-Especially Hemodynamic and Respiratory Management
Current Psychiatry Reviews Hyperpolarized <sup>13</sup>C MR Angiography
Current Pharmaceutical Design Diabetes as a Negative Risk Factor for Abdominal Aortic Aneurysm – Does the Disease Aetiology or the Treatment Provide the Mechanism of Protection?
Current Vascular Pharmacology Recent Advances in Management of Diabetic Macular Edema
Current Diabetes Reviews Modulation of Collagen Turnover in Cardiovascular Disease
Current Pharmaceutical Design Myocardial Infarction in Systemic Lupus Erythematosus – the Sex-Specific Risk Profile
Current Pharmaceutical Design Therapeutic Angiogenesis in Ischemic Tissues by Growth Factors and Bone Marrow Mononuclear Cells Administration: Biological Foundation and Clinical Prospects
Current Stem Cell Research & Therapy