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Selective intestinal decontamination for the prevention of early bacterial infections after liver transplantation

World Journal of Gastroenterology 2016年第26期22卷 5950-5957页

作者： Elena Resino Rafael San-Juan Jose Maria Aguado Unit of Infectious Diseases 12 de Octubre University Hospital

bacterial infection in the first month after liver transplantation is a frequent complication that poses a serious risk for liver transplant recipients as contributes substantially to increased length of hospitalization and hospital costs being a leading cause of death in this period. Most of these infections are caused by gramnegative bacilli, although gram-positive infections, especially Enterococcus sp. constitute an emerging infectious problem. This high rate of early postoperative infections after liver transplant has generated interest in exploring various prophylactic approaches to surmount this problem. One of these approaches is selective intestinal decontamination(SID). SID is a prophylactic strategy that consists of the administration of antimicrobials with limited anaerobicidal activity in order to reduce the burden of aerobic gram-negative bacteria and/or yeast in the intestinal tract and so prevent infections caused by these organisms. The majority of studies carried out to date have found SID to be effective in the reduction of gram-negative infection, but the effect on overall infection is limited due to a higher number of infection episodes by pathogenic enterococci and coagulase-negative staphylococci. However, difficulties in general extrapolation of the favorable results obtained in specific studies together with the potential risk of selection of multirresistant microorganisms has conditioned controversy about the routinely application of these strategies in liver transplant recipients.

关键词： Selective intestinal decontamination Liver transplant infection gram-negative bacterial infection gram-positive bacterial infection Multirresistant

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Clinical efficacy and safety of linezolid in intensive care unit patients

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Journal of Intensive Medicine 2023年第1期3卷 65-72页

作者： Aijia Ma Meiling Dong Jiangli Cheng Xuelian Liao Wei Dong Chang Liu Chenggong Hu Jing Yang Yan Kang Department of Critical Care Medicine West China Hospital of Sichuan UniversityChengduSichuan 610041China

Background:To characterize the population of critically ill patients and infections treated with linezolid in the intensive care unit(ICU),and to evaluate the clinical efficacy and safety of linezolid ***::This multi-center,observational,real-world study was conducted across 52 hospitals between June 9,2018,and December 28,*** who met the following inclusion criteria were included:(1)admitted to the ICU,(2)of any age group,and(3)having a clinical or laboratory diagnosis of a gram-positive bacterial *** efficacy was categorized as success(cured or improved),failed,or *** events and serious adverse events were recorded during ***::A total of 366 ICU patients who met the inclusion criteria were *** was used as second-and first-line treatment in 232(63.4%)and 134(36.6%)patients,*** most common isolated strain was Staphylococcus aureus(methicillin-resistant Staphylococcus aureus:n=37/119,31.1%;methicillin-susceptible Staphylococcus aureus:n=15/119,12.6%);this was followed by Enterococci(vancomycin-resistant Enterococci:n=8/119,6.7%;vancomycin-susceptible Enterococci:n=11/119,9.2%)and Streptococcus pneumoniae(multidrug-resistant:n=4/119,3.4%;non-multidrug resistant:n=2/119,1.7%).The main infection sites where pathogens were detected included the lung(n=216/366,59.6%),skin and soft tissue(n=104/366,28.4%),and blood(n=50/366,13.7%).Clinical success was achieved in 301(82.2%)patients;34(9.3%)were cured and 267(73.0%)improved;treatment failure and non-evaluable outcomes were observed in 29(7.9%)in 36(9.8%)patients,***-related adverse events were reported in 8(2.2%)*** treatment-related serious adverse events were ***::Based on real-world results,linezolid was found to be effective and safe in the treatment of gram-positive bacterial infections in critically ill patients.

关键词： Intensive care unit Linezolid Real-world study gram-positive bacterial infection

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