在医疗保健环境中纠正Clostridioides difficile归因的新方法
Hunter Doyle1, Abby L Valek2, Theresa Murillo3
1Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
Antimicrobial stewardship & healthcare epidemiology : ASHE
|December 29, 2023
概括
一种新的方法来追踪由Clostridioides difficile引起的与医疗保健相关的感染,将归因从住院病房转移到其他环境. 这一新型指标可能会改善减少C. difficile感染的努力.
科学领域:
- 传染性疾病 传染性疾病
- 医疗卫生流行病学 医疗卫生流行病学
- 公共卫生监督 公共卫生监督
背景情况:
- 由于 Clostridioides difficile (C. difficile) 的医疗保健相关感染 (HAI) 在急性护理环境中构成了重大挑战.
- 目前的监测方法,如美国国家医疗保健安全网络 (NHSN),可能无法准确地确定C. difficile传播的来源.
- 准确的感染源归因对于有效的感染控制和预防策略至关重要.
研究的目的:
- 介绍和描述一种新的归因指标,用于估计与医疗保健相关的C. difficile.的因果源位置.
- 将这个新指标的性能与当前的NHSN监控报告标准进行比较.
- 评估新型指标如何与已建立的NHSN方法相比重新分配归因,特别是关于住院病房的单位.
主要方法:
- 在两个急性护理机构进行了一项质量改进研究.
- 开发了一种新的归因指标,将归因日分配给患者的位置,在C. difficile诊断的前14天内,包括诊断日.
- 该研究将NHSN分配的单位归因与新型指标相关联,并比较了分配给住院单位的归因比例.
主要成果:
- 在30个月的时间里,记录了727例C. difficileHAI和409例非HAI.
- 新的指标显示了与NHSN归因的温和相关性 (单位和设施的系数从0.69到0.79不等).
- 与NHSN测量相比,新型指标导致归因从住院病房转移到其他环境.
结论:
- 新的归因指标有效地将C. difficile的归因从住院病房转移到其他潜在来源.
- 该指标与当前的NHSN方法论有着适度的相关性.
- 进一步验证这一新型归因指标可能会导致更精确地针对C. difficile减少举措.
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