Ibicuruzwa

1.Indwara zanduye methicilline irwanya indwara ya Staphylococcus aureus yiyongera ku muvuduko uteye ubwoba.Kuvura neza byagize uruhare mu mateka ya débridement hakiri kare no kuyobora antibiotique.Ubu bushakashatsi bwakozwe hagamijwe kumenya neza uburyo bwo kuvura indwara zifatika mu kuvura indwara zanduye. Ikigeragezo giteganijwe cyakozwe ku bitaro byo ku rwego rwa I.Abarwayi banduye intoki bakiriye vancomycine yo mu maraso yinjira cyangwa yinjira muri cefazoline.Ibisubizo byakurikiranwe hakoreshejwe ubukana bwanduye, ibisubizo bikwiye byubuvuzi, hamwe nigihe cyo kumara.Ikiguzi-cyiza cyabazwe ukoresheje ikiguzi cyose kuri buri murwayi mumatsinda yombi.Isesengura mibare ryakozwe. Abarwayi mirongo ine na batandatu bariyandikishije mu bushakashatsi.24 ni bo batoranijwe kuri cefazoline (52.2 ku ijana) na 22 (47.8 ku ijana) kuri vancomycine.Nta tandukanyirizo ryibarurishamibare ryari hagati yikiguzi cyo kwivuza (p <0,20) cyangwa bivuze uburebure bwo kumara (p <0.18) betw een amatsinda.Abarwayi batoranijwe kuri cefazolin bari bafite amafaranga menshi yo kwivuza ugereranije n’abarwayi batoranijwe na vancomycine (p <0.05).Abarwayi bafite ubwandu bukabije bafite amafaranga menshi yo kuvura (p <0.0001) kandi birebire bisobanura igihe cyo kumara (p = 0.0002).Hafi y’ubushakashatsi burangiye, byagaragaye ko indwara ya S. aureus yanduye methicilline y’abaturage mu bitaro by’intara y’abanditsi yavumbuwe ko ari 72 ku ijana, ibyo bikaba byaratumye ubushakashatsi burangira imburagihe n’inama y’isuzumamikorere kubera ibigo byinshi. kubuza gukomeza gutoranya.Ubuvuzi bukwiye bwo kuvura methicilline irwanya S. aureus ntabwo bwashyizweho neza.Nta tandukanyirizo ryibisubizo ukoresheje cefazolin na vancomycin nkumukozi wambere wumurongo wamenyekanye.

2. Hamwe nogutezimbere gukira ibikomere hifashishijwe antibiyotike ya prophylactique yimitsi no kunonosora tekiniki, kwandura inkokora nyuma yo kubagwa ntibyakunze kugaragara ariko biracyagaragara mugikorwa cyo kubaga inkokora zatoranijwe.Icyari kigamijwe muri ubu bushakashatsi kwari ugusuzuma umutekano n’akamaro ko gukoresha imiti ya vancomycine mu rwego rwo kugabanya kwandura indwara nyuma yo kurekurwa ku mugaragaro inkokora zikomeye nyuma y’ihungabana. igihe cyakozwe.Mu itsinda rishinzwe kugenzura (abarwayi 93), hakozwe prophylaxis yoroshye hamwe na antibiyotike zisanzwe zinjira mu mitsi;mu itsinda rya vancomycine (abarwayi 179), ifu ya vancomycine yashyizwe mu gikomere mbere yo gufunga hamwe na prophylaxis isanzwe yinjira. Nyuma yo gukurikirana byibuze amezi 6, itsinda rishinzwe kugenzura wasangaga ryanduye 6 (6.45%; intera: 2,40% -13.52%) ugereranije ntanumwe (0%; intera yicyizere: 0-2% .04%) mumatsinda ya vancom ycin, yari itandukaniro rikomeye mubarurishamibare (P = .0027).Nta ngaruka mbi zanditswe zivuye mu gukoresha mu buryo butaziguye ifu ya vancomycine. Gukoresha ifu ya vancomycine birashobora kuba uburyo butanga ikizere cyo gukumira indwara zanduza nyuma yo kubagwa nyuma yo kurekura inkokora ku barwayi bafite inkokora nyuma yo guhahamuka.