影响万科米辛耐药菌菌 (Enterococcus faecium) 在不同病房住院患者的殖民化的因素
Yun-Cheng Wang1, Lih-Shinn Wang2, Tsung-Cheng Hsieh3
1Department of Infection Prevention and Control, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Tzu chi medical journal
|February 26, 2024
概括
在台湾,抗万科胺素的Enterococcus faecium (VRE) 感染率很高. 对VRE定居的风险因素因病房而异,需要个性化查和量身定制的感染控制政策.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 临床微生物学 临床微生物学
背景情况:
- 越来越多的抗万科胺素Enterococcus faecium (VRE) 感染在台湾,在区域医疗中心达到80.6%,明显高于全国平均水平.
- 在住院患者中,每年越来越多地检测到VRE感染,许多病例涉及无症状携带者.
- 需要确定VRE殖民化的特定风险因素,以告知广泛查之外的有效感染控制策略.
研究的目的:
- 为了调查与不同医院病房的抗万科米辛抗性Enterococcus faecium (VRE) 殖民相关的独特风险因素.
- 为改进VRE感染控制政策和查方案提供基于证据的建议.
主要方法:
- 在2014年至2019年期间报告的3188种VRE阳性培养物的回顾性分析.
- 使用电子医疗记录来识别患者数据和抗生素暴露.
- 基于在各种医院环境中使用抗生素来确定VRE殖民的几率比率的统计分析.
主要成果:
- 青素和第三代头素的使用是医疗和外科病房VRE定居的重要风险因素 (ORs 2.84-6.19).
- 卡巴胺使用成为重症监护室中VRE殖民化的最重要的风险因素 (OR 2.08).
- 在不同医院病房之间确定了与抗生素相关的VRE定居的独特风险因素.
结论:
- VRE殖民化的风险因素是病房特定的,这表明一种适合所有人的查和控制方法是不够的.
- 感染控制政策应根据每个病房的特定患者群体和抗生素使用模式量身定制.
- 积极的VRE查应根据个体患者的因素进行风险分层,而不是作为通用查措施实施.
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