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普遍查或普遍风险评估结合在入院时针对多药耐药微生物的基于风险的查:比较策略

Adriënne S van der Schoor¹, Juliëtte A Severin¹, Corné H W Klaassen¹

¹Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

|July 25, 2023

概括

在入院时对多药耐药微生物 (MDRO) 的普遍查可以识别比单独的风险评估更多的携带者. 这种方法对于预防医院传播至关重要,特别是在低流行率的环境中.

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
流行病学流行病学

背景情况:

在医院中预防多药耐药微生物 (MDRO) 的传播至关重要.
目前的策略通常依赖于风险评估,这可能会错过无症状携带者.
需要有效的查方法,以便及时识别患者.

研究的目的:

为了比较普遍查与风险评估在入院时识别MDRO载体的有效性.
在预期的队列中评估每个战略的收益率.

主要方法:

在一个前性队列中进行了一项观察性研究.
在2018年1月至2019年9月期间入院的患者接受了MDRO.的普遍查 (鼻腔和周样本).
关于普遍风险评估的数据是追溯收集的.

主要成果:

全面查发现了3.6%的未知MDRO载体 (主要是扩展光谱β-lactamase产生的肠杆菌),明显超过风险评估 (0.1%).
大多数通过普遍查发现的携带者 (94.6%) 没有发现的风险因素.
全面查在检测MDRO载体方面显示出更高的收益率.

结论:

在低患病率的环境中,在入院时识别MDRO载体时,普遍查比风险评估更有效.
风险评估策略需要仔细选择风险因素来检测载体.
需要进一步研究普遍查的成本效益.

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