艰难的Clostridioides爆发的检测:评估 ribotyping 和全基因组测序的监控算法,基于病房特定的切断线
Jon E Edman-Wallér1,2, Michael Toepfer3, Johan Karp1,4
1Centre for Antibiotic Resistance Research (CARe), Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Infection control and hospital epidemiology
|June 23, 2023
概括
在医院中检测Clostridioides difficile传播的早期预警算法没有比机会更好. 监测必须考虑的不仅仅是诊断位置,特别是与多种菌株.
科学领域:
- 传染病流行病学 传染病流行病学
- 在医院获得的感染.
- 分子流行病学分子流行病学
背景情况:
- 艰难 Clostridioides (C. diff) 感染在医疗保健机构中构成重大威胁.
- 有效的监测对于控制C. diff传播至关重要.
- 早期预警算法旨在主动检测疫情爆发.
研究的目的:
- 评估C. diff传播检测的早期预警算法,使用病房特定的发病率切断.
- 为了确定西瑞典医院内C.diff传播的频率.
主要方法:
- 该研究使用高分子量类型,病房病史,PCR核型和全基因组测序 (WGS) 来识别传播事件.
- 对算法的诊断性能进行了评估,并与已确认的传播事件对比.
- 在2020-2021年期间,从四家医院的673个阳性C.diff样本收集了数据.
主要成果:
- 确定了四个C.diff传播群,涉及10名患者 (1.5%).
- 早期预警算法表现得没有比偶然性更好.
- 传染事件通常发生在不同于患者诊断的病房.
结论:
- 病房特定的发病率截止值不足以有效监测C. diff传播.
- 仅仅考虑诊断病房就会忽略传播动态,特别是在各种压力环境中.
- 在所研究的环境中,医院内C.diff的传播似乎是零星的.
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