Factors Associated With Laboratory Test Negativity Following a Transition in Specimen Collection in Microbial Keratitis Cases.
Factors Associated With Laboratory Test Negativity Following a Transition in Specimen Collection in Microbial Keratitis Cases.
复制标题
微生物性角膜炎病例标本采集转变后与实验室检测阴性相关的因素。
DOI：
10.1080/02713683.2023.2294700
复制
发表时间：
2024
影响因子：
2
通讯作者：
Woodward,MariaA
中科院分区：
文献类型：
--
作者：
Miller,KeithD;Toiv,Avi;Deng,Callie;Lu,Ming-Chen;Niziol,LeslieM;Hart,JennaN;Sherman,Eric;Mian,ShahzadI;Lephart,PaulR;Sugar,Alan;Kang,Linda;Woodward,MariaA
目的实验室阴性结果使靶向治疗微生物性角膜炎变得困难。我们调查的背景下，过渡到一个新的标本采集methodsMethodsMicrobial角膜炎患者的实验室阴性相关的因素与相关的实验室检查被确定在电子健康记录的三级保健设施从2012年8月至2022年4月。获得患者人口统计学和实验室结果。对50%的视力表进行随机抽样，以评估眼部病史和治疗前措施的影响。负的实验室结果与人口统计学，眼的历史，预处理措施，并利用一个新的标本采集方法（即ESwab）的概率之间的关系进行了评估，通过多变量logistic regression.ResultsOf 3395微生物角膜炎患者确定，31%（n= 1051）进行实验室检查。实验室检测随着时间的推移而增加（斜率=每年2.5%，p< 0.001; 2013年为19.6%，2021年为42.2%）。实验室阴性率随时间增加（斜率=每年2.2%，p= 0.022; 2013年为48.5%，2021年为62.3%）。近三分之一的患者（31.2%，n = 164）接受了类固醇预治疗。超过三分之二的患者（69.5%，n = 367）接受了抗生素治疗。56.5%（n= 297）的患者为外部转诊。在多变量回归分析中，糖皮质激素预治疗的患者实验室检查结果阴性的几率较低（比值比[OR] = 0.49，p = 0.001）。在就诊前为患者开具的每一种额外抗生素（OR = 1.30，p = 0.006）和使用ESwabs采集的标本（OR = 1.69，p = 0.005）的阴性实验室结果几率更高。年龄，以前的眼外伤，外部转介，接触透镜磨损与阴性实验室结果没有显着相关性。到2022年，超过60%的检测结果为阴性。与阴性实验室检测结果相关的因素包括抗生素预处理和采用新的采集方法采集的标本。
PurposeNegative laboratory results make targeting microbial keratitis treatment difficult. We investigated factors associated with laboratory negativity in patients with microbial keratitis in the context of a transition to a new specimen collection method.MethodsMicrobial keratitis patients with associated laboratory tests were identified in the electronic health record of a tertiary care facility from August 2012 to April 2022. Patient demographics and laboratory results were obtained. Random sampling of 50% of charts was performed to assess the impact of the ocular history and pretreatment measures. The relationship between probability of negative laboratory results with demographics, ocular history, pretreatment measures, and utilization of a new specimen collection method (i.e. ESwab) was evaluated by multivariable logistic regression.ResultsOf 3395 microbial keratitis patients identified, 31% (n= 1051) had laboratory tests. Laboratory testing increased over time (slope = 2.5% per year,p< 0.001; 19.6% in 2013 to 42.2% in 2021). Laboratory negative rate increased over time (slope = 2.2% per year,p= 0.022; 48.5% in 2013 to 62.3% in 2021). Almost one-third of patients (31.2%,n= 164) were pretreated with steroids. Over two-thirds of patients were pretreated with antibiotics (69.5%,n= 367). 56.5% (n= 297) of patients were outside referrals. In multivariable regression, patients with corticosteroid pretreatment had lower odds of negative laboratory results (odds ratio [OR] = 0.49,p= 0.001). There were higher odds of negative laboratory results for every additional antibiotic prescribed to a patient prior to presentation (OR = 1.30,p= 0.006) and for specimens collected using ESwabs (OR = 1.69,p= 0.005). Age, prior eye trauma, outside referrals, and contact lens wear were not significantly associated with negative laboratory results.ConclusionMore microbial keratitis associated laboratory tests are being taken over time. Over 60% of tests were negative by 2022. Factors associated with negative laboratory test results included pretreatment with antibiotics and specimens collected with the new collection method.
登录
查看更多内容
氯化铝诱导发育中兔子的神经原纤维变化：慢性动物模型
影响因子：
11.2
作者：
H. Wiśniewski;J. Sturman;J. Shek
通讯作者：
J. Shek
运动神经元的实验性神经毒性疾病：神经原纤维病理学。
影响因子：
--
作者：
Griffin,J;Cork,LC;Troncoso,JC;Price,DL
通讯作者：
Price,DL
神经结扎上方丙烯酰胺引起的轴突超结构变化
影响因子：
5
作者：
J. Cavanagh;M. F. GYSBERS
通讯作者：
M. F. GYSBERS
丙烯酰胺中毒的病理动力学：对该问题的重新评估
影响因子：
5
作者：
J. Cavanagh
通讯作者：
J. Cavanagh
影响因子：
5.3
作者：
A. Hernández;E. Muñoz‐Martinez
通讯作者：
E. Muñoz‐Martinez