在重症监护室进行抗甲素耐药黄金葡萄球菌检测的变化作为一种抗菌药物管理倡议
Hayden L Smith1, Samuel P DuMontier1, Amanda M Bushman2
1Medical Education Services, UnityPoint Health-Des Moines, Des Moines, IA.
Ochsner journal
|June 16, 2023
概括
在ICU中切换到聚合酶链反应 (PCR) 进行甲基耐药黄金葡萄球菌 (MRSA) 测试,显著减少了结果的周转时间. 快速的MRSA测试结果通过优化菌素的使用来帮助抗菌药物管理.
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
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 甲素耐药黄金葡萄球菌 (MRSA) 感染在重症监护病房 (ICU) 造成严重的发病和死亡风险.
- 范科米辛是MRSA的主要治疗方法,但具有固有的风险,需要谨慎管理.
研究的目的:
- 评估将MRSA诊断方法从培养转为PCR及时转换对成年ICU的结果的影响.
- 评估加速MRSA测试结果对抗微生物药物管理实践的影响.
主要方法:
- 从培养到PCR的MRSA测试策略的变化在美国中西部卫生系统中的两个ICU (三级和社区) 实施.
- 分析了2016-2020年的数据,重点关注在干预之前和之后获得MRSA测试结果的时间中位数变化.
主要成果:
- 在研究期间,在19,975名ICU患者中,MRSA测试对71%进行.
- 实施PCR检测导致结果的时间大幅缩短,估计在高等医院和社区医院分别节省了36小时和32小时.
- 基于文化的测试在干预后急剧下降,几乎已经过时了.
结论:
- 过渡到基于PCR的MRSA测试大大减少了在ICU获得结果所需的时间.
- 加快的MRSA测试结果支持抗微生物药物管理,允许及时启动或缓解像万科米辛这样的疗法.
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