病院や介護施設における地域脱植民地化による入院および多剤耐性生物の減少

Gabrielle M Gussin¹, James A McKinnell², Raveena D Singh¹

¹Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine.

JAMA

|April 1, 2024

まとめ

地域脱植民地化イニシアチブは,多剤耐性生物 (MDRO) の流行,感染,入院,および関連する費用を削減しました. この品質改善の取り組みは長期的なケアや急性ケアにおいて顕著な効果を示した.

科学分野:

感染症
公衆衛生
品質の向上

背景:

多剤耐性菌 (MDRO) の感染は重篤な患者の結果と医療費の増加をもたらします.
地域的な介入はMDROに対抗するための拡張可能な解決策を提供できる.

研究の目的:

MDROの流行と関連する臨床結果に対する地域脱植民地化協力の影響を評価する.
塩素ヘキシジンの入浴と鼻用ヨドフォール消毒剤の有効性を評価する.

主な方法:

2017年7月から2019年7月までのカリフォルニアの35の医療施設を対象とした品質改善研究.
長期介護施設における普遍的な脱植民化の実施と,接触予防措置として入院患者の標的型脱植民化の実施.
MDROポイントの流行,インシデントの臨床培養,感染関連の入院,費用,死亡のモニタリング.

主要な成果:

MDROの罹患率は介護施設 (63. 9%から49. 9%) と長期急症病院 (80. 0%から53. 3%) で著しく減少した.
参加施設では,発生したMDRO培養,感染関連の入院,費用,死亡が減少しました.
介護施設では,感染関連の入院 (26. 7%) と費用 (26. 8%) が著しく減少した.

結論:

地域脱植民地化協力により,MDROの輸送と関連する感染が効果的に減少しました.
この介入は,入院率,医療費,死亡率に好ましい影響を及ぼしました.
このアプローチは,感染制御における連携した地域戦略の可能性を強調しています.

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