每天进行赫西丁浴,以减少重症儿童的细菌病:一个多中心,集群随机,交叉试验
Aaron M Milstone1, Alexis Elward, Xiaoyan Song
1Department of Pediatrics, Division of Pediatric Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. amilsto1@jhmi.edu
Lancet (London, England)
|February 1, 2013
概括
每日素酸盐 (CHG) 洗可降低严重病症儿童的血液感染 (细菌病). 这种耐受良好的干预措施为改善儿科重症监护病房患者的治疗结果提供了一个有希望的策略.
科学领域:
- 传染病流行病学 传染病流行病学
- 儿科重症监护医学 儿科重症监护医学
- 抗微生物药物管理委员会
背景情况:
- 细菌血症对重症儿童构成重大威胁,导致大量的发病率和死亡率.
- 标准的洗方法可能无法充分预防这种脆弱人群的血液感染.
研究的目的:
- 评价每日素酸盐 (CHG) 洗对降低重症儿童细菌病发病率的有效性.
- 为了比较CHG浴与儿童重症监护病房的标准浴方案.
主要方法:
- 一个集群随机化,两期交叉试验,涉及五家医院的十个儿科重症监护病房.
- 两个月以上的患者接受2%的CHG浸布或六个月的标准洗,单位在研究中期切换协议.
- 对4947名符合条件的入院者进行了治疗意向 (ITT) 和每协议 (PP) 分析.
主要成果:
- 每项方案分析显示,与标准护理 (每1000天4.93) 相比,CHG浴 (3.28每1000天) 的细菌病发病率在统计学上显著降低.
- 对治疗意图的分析表明,在CHG浴中减少细菌病的趋势并不显著 (3.52对每1000天4.93).
- 人们对CHG浴的耐受性很好,皮肤反应的发病率很低 (1.2每1000天).
结论:
- 每日CHG洗是一种有效和安全的方法,可以降低重症儿童的细菌病发病率.
- 这种干预措施对儿科重症监护机构的感染控制策略构成了有价值的补充.
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