在成人重症监护病房的搬迁和扩张之前和之后,常见的微生物分离物
Alice J Liu1,2, Alison Wells3, Jeffrey Presneill3,4
1General Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia.
概括
将成人重症监护病房 (ICU) 转移到单人病房并没有改变关键医院病原体的流行率. 这表明,改进的基础设施可能会提高重症监护的安全性,即使瘤病患负担增加.
科学领域:
- 感染控制和医院流行病学
- 关键护理医学 关键护理医学
- 微生物学 微生物学
背景情况:
- 重症监护病房 (ICU) 是病房感染的高风险环境.
- 病房的设计,包括病人的住宿,可能会影响感染率.
- 患者病情的变化,例如瘤病人的增加,可能会影响感染动态.
研究的目的:
- 评估将成年人重症监护室从开放式重症监护室搬迁到单间重症监护室的设计对常见微生物分离物的流行影响.
- 评估在ICU物理搬迁和瘤病房扩建之前和之后细菌隔离频率的变化.
主要方法:
- 在四年 (2014-2018) 期间进行了回顾性,观察性,描述性分析.
- 数据是在2016年5月5日重症监护室搬迁前两年和之后两年收集的.
- 细菌分离频率和事件率比率 (IRR) 在旧和新ICU设置之间进行了比较.
主要成果:
- 在新的ICU中,每1000个被占用病床日的总体细菌隔离物发病率下降 (IRR,0.88).
- 观察到凝血酶负型葡萄球菌 (IRR,0.64) 和抗万科米辛的肠球菌 (IRR,0.50) 的显著减少.
- 黄金葡萄球菌 (IRR,1.1),扩展光谱β-乳糖酶产生生物体 (IRR,1.4) 和碳酶产生肠杆菌 (IRR,0.85) 的发病率保持不变.
结论:
- 搬迁到单间ICU设计并没有增加常见的医院病原体的流行率,如金黄色细菌或耐药细菌.
- 调查结果表明,加强物理基础设施,包括单人病房,可能有助于更安全的重症监护服务.
- 改善ICU设计可能是减轻感染风险的关键因素,即使患者人数在不断变化.
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