预防ICU获得感染的免疫功能低下患者的消毒方案:一个前/后观察性研究
Nicolas Massart1, Clarisse Dupin2, Eleonore Legris3
1Service de Réanimation, CH de St BRIEUC, 10, Rue Marcel Proust, 22000, Saint-Brieuc, France. nicolasmassart@hotmail.fr.
概括
多部位消毒 (MSD) 显著降低了重症监护室获得的感染 (ICU-AIs) 和免疫受损患者的死亡率. 这种感染预防策略为需要机械通风的重症患者提供了更好的结果.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 在重症监护室 (ICU) 的免疫功能低下患者数量正在上升.
- 关于特定管理策略的数据,包括重症监护室获得的感染 (ICU-AIs) 的预防,对于这个脆弱的人群来说是有限的.
研究的目的:
- 研究多部位消毒 (MSD) 方案在预防免疫受损患者中ICU-AI的有效性.
- 评估MSD对该患者群的死亡率的影响.
主要方法:
- 在两个ICU中进行了前性前/后观察性研究.
- 符合条件的患者需要机械通风至少24小时.
- 该MSD疗法包括局部抗生素,赫西丁洗剂和鼻子mupirocin,除了标准护理外,还应用于鼻子.
主要成果:
- 这项研究分析了295名免疫受损患者 (143名MSD前,151名MSD后).
- 脊髓硬化症与ICU-AIs的显著减少有关 (35例在29/143例患者中,相比10例在9/151例患者中;p < 0.001).
- 此外,MSD与死亡率降低相关 (35/143例死亡与22/151例死亡;p = 0.046).
结论:
- 多部位消毒 (MSD) 表明,在重症免疫受损患者中,与减少ICU获得的感染有显著的关联.
- 实施MSD疗法似乎可以改善这种高风险人群的临床结果,包括存活率.
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