在更新护理包后,减少了与外腔室管切除相关的感染
Mariel Rojas-Lora1,2, Luisa Corral3,4, Ivan Zabaleta-Carvajal5
1Intensive Care Department, Servei de Medicina Intensiva, IDIBELL-Hospital Universitari de Bellvitge, Feixa Llarga S/N, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
Annals of clinical microbiology and antimicrobials
|July 15, 2023
概括
实施新协议显著减少了与外腔室排水相关的感染 (EVDRI),特别是那些由格拉姆阴性细菌引起的感染. 这种最新的方法降低了感染率和患者康复时间.
科学领域:
- 神经外科 神经外科
- 传染性疾病 传染性疾病
背景情况:
- 外腔室排水管 (EVD) 对于管理神经疾病至关重要,但存在EVD相关感染 (EVDRI) 的风险.
- 虽然阳性细菌是EVDRI的常见原因,但阴性细菌是这家医院的主要关注点.
- 标准化的插入技术和指导方针对于预防感染至关重要.
研究的目的:
- 评估一系列新措施在减少EVDRI发病率方面的有效性.
- 为了比较2017年更新协议 (UP) 实施之前和之后的EVDRI率.
主要方法:
- 一项队列研究包括了198名患者,他们在2015年1月1日至2018年12月31日期间需要插入EVD.
- 患者被分为两组:更新协议之前 (87名患者) 和更新协议后 (111名患者).
- 关键的诊断包括下arachnoid (42%) 和脑内 (24%) 的出血.
主要成果:
- 在实施UP后,EVDRI的发病率从每1000个导管天减少了13.4至2.5次.
- 格拉姆阴性细菌仍然是最常见的EVDRI病因.
- 以前的切除术是EVDRI的唯一独立风险因素;受影响的患者需要更长的机械呼吸,住院/ICU住院和气管切除术.
结论:
- 一个强调减少导管采样和加强消毒措施的护理包显著降低了EVDRI发病率.
- 更新的管理协议导致了格拉姆阴性和格拉姆阳性细菌感染的减少.
- 观察到的好处包括减少了ICU和住院时间.
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