■在印度医疗机构中,耐碳青霉烯类肠杆菌(CRE)感染日益严峻的挑战要求对这些感染的管理提供明确的临床指导。印度关于危重患者CRE感染管理的共识(ICONIC-II)是ICONIC-I研究的随访,这是2019年进行的。
■使用改进的德尔菲方法来建立印度CRE管理的专家共识,涉及在线调查,面对面的专家会议,和文献综述。成立了由12名专家组成的小组,以制定潜在的临床共识声明(CCS)。通过两轮调查进行了评级。在最后的面对面讨论中最终确定了CCS。最终确定的CCS被归类为共识,接近共识,没有共识。
■结果包括46个CCS(共识:40;接近共识:3;无共识:3)。专家小组讨论了管理CRE感染的各种策略并达成共识,强调现有和新兴抵抗机制的重要性,及时和量身定制的经验性治疗,并使用联合疗法。基于专家组集体专业知识的共识声明可能会帮助临床医生管理缺乏高水平证据的CRE感染。
UNASSIGNED: The rising challenge of carbapenem-resistant Enterobacterales (CRE) infections in Indian healthcare settings calls for clear clinical guidance on the management of these infections. The Indian consensus on the management of CRE infection in critically ill patients (ICONIC-II) is a follow-up of the ICONIC-I study, which was undertaken in 2019.
UNASSIGNED: A modified Delphi method was used to build expert
consensus on CRE management in India, involving online surveys, face-to - face expert meetings, and a literature review. A panel of 12 experts was formed to develop potential clinical
consensus statements (CCSs), which were rated through two survey rounds. The CCSs were finalized in a final face-to - face discussion. The finalized CCSs were categorized as
consensus, near
consensus, and no
consensus.
UNASSIGNED: The outcomes included 46 CCSs (
consensus: 40; near
consensus: 3; and no
consensus: 3). The expert panel discussed and achieved
consensus on various strategies for managing CRE infections, emphasizing the significance of existing and emerging resistance mechanisms, prompt and tailored empiric therapy, and use of combination therapies. The consensus statements based on the collective expertise of the panel can potentially assist clinicians in the management of CRE infections that lack high-level evidence.