在住院成年人中,对除Clostridium difficile外的肠病原细菌进行便培养的指导方针的推导和验证
T M Bauer1, A Lalvani, J Fehrenbach
1Department of Internal Medicine II, University Hospital Freiburg, Hugstetterstrasse 55, D-79106 Freiburg, Germany. bauert@med1.ukl.uni-freiburg.de
JAMA
|February 15, 2001
概括
医院便培养的修改后的3天规则有效地识别了肠病原细菌 (EPB) 和疫情,减少了不必要的测试. 这种方法确保了对医院腹病例的敏感检测,同时提高了成本效益.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 医院流行病学 医院流行病学
背景情况:
- 在入院72小时后进行的医院便培养具有低产量,并且经常被拒绝以削减成本.
- 这个这个这个这个这个
- 三天规则是三天规则.
- 政策可能会错过由Clostridium difficile (EPB) 以外的肠病原细菌引起的医院感染.
研究的目的:
- 为医院便培养物使用制定指南.
- 准则应对临床相关的零星和流行性医院性腹病例敏感.
主要方法:
- 这是一项由五部分组成的研究,涉及来自四个欧洲学术医疗保健中心的衍生和验证样本.
- 进行了回顾性图表审查和前性队列研究,包括成本节约分析.
- 标准来自与EPB隔离>72小时后入院相关的患者特征.
主要成果:
- 与72小时 (3.3%) 相比,EPB隔离时间明显低于>72小时后 (0.5%).
- 超过72小时的EPB隔离与社区获得的腹,伴随疾病的老年,中性质减退,艾滋病毒和非腹性肠道表现有关.
- 应用衍生标准使便培养减少了52%,没有错过临床重要病例,每年节省约7800美元和75个技术人员小时.
结论:
- 修改后的3天规则用于便培养的选择对住院成人的零星和流行性医院性腹敏感.
- 这种修订后的方法提高了医院微生物学诊断产量和成本效益.
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