患病率和与甲基西林耐药黄金葡萄球菌在老年护理单位入院时的殖民化相关的因素:对查实践的影响
A Bruyneel1, I Miesse2, D Mathieu3
1Hospital Outbreak Support Team, Réseau Hospitalier Universitaire Cœur de Wallonie, Belgium; Health Economics, Hospital Management and Nursing Research Department, School of Public Health, Université Libre de Bruxelles, Belgium.
The Journal of hospital infection
|February 3, 2024
概括
在老年病房使用患者病史,养老院来源和皮肤病变的有针对性查甲素耐药黄金葡萄球菌 (MRSA) 可以减少不必要的查. 这种方法保持了在入院时识别MRSA殖民的高准确性.
科学领域:
- 传染性疾病 传染性疾病
- 老年医学 老年医学
- 流行病学 流行病学
背景情况:
- 对抗甲素黄金葡萄球菌 (MRSA) 的普遍查是昂贵的,在高风险老年病房没有明确的针对性查指南.
- 识别MRSA殖民的高风险患者对于有效的感染控制策略至关重要.
研究的目的:
- 为了确定老年护理单位MRSA的流行率.
- 确定在入住老年护理单位时与MRSA殖民相关的因素.
主要方法:
- 在2021年1月至2022年12月期间,在比利时的六个老年护理单位进行了回顾性病例控制研究 (1:1比).
- 病例是入院后48小时内呈阳性MRSA查的患者;对照组的查结果为负.
主要成果:
- 总体MRSA患病率为每100例入院病例中的2.3.
- 与MRSA殖民相关的重要因素包括先前的MRSA病史,养老院来源和慢性皮肤病变.
- 使用这些因素的模型实现了0.73的ROC曲线下的面积,可能将查减少到55.4%的患者.
结论:
- 基于MRSA病史,养老院来源和皮肤病变的查标准的实施可以显著减少老年护理中查的患者数量.
- 这种有针对性的方法在减少查数量和保持对MRSA检测的满意灵敏度和特异性之间提供了平衡.
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