通过医院和养老院的区域去殖民化减少住院和抗药性生物
Gabrielle M Gussin1, James A McKinnell2, Raveena D Singh1
1Division of Infectious Diseases, University of California Irvine School of Medicine, Irvine.
JAMA
|April 1, 2024
概括
一个区域脱殖民化倡议减少了多抗药生物体 (MDRO) 的流行,感染,住院和相关成本. 这项质量改善工作在长期护理和急性护理环境中显示出显著的好处.
科学领域:
- 传染性疾病
- 公共卫生
- 提高质量
背景情况:
- 多种耐药生物 (MDRO) 感染导致患者的严重后果和医疗费用增加.
- 区域干预可以提供可扩展的解决方案来打击MDRO.
研究的目的:
- 评估区域脱殖合作对MDRO患病率和相关临床结果的影响.
- 评估化浴和鼻消毒剂在减少MDROs方面的有效性.
主要方法:
- 一项从2017年7月到2019年7月参与加利福尼亚35家医疗机构的质量改进研究.
- 在长期护理机构实施普遍脱殖,并针对住院患者采取接触预防措施.
- 监测MDRO点患病率,临床培养,感染相关住院,费用和死亡情况.
主要成果:
- 在养老院 (63.9%至49.9%) 和长期急症医院 (80.0%至53.3%) 中,MDRO的患病率显著下降.
- 参与的设施减少了发生的MDRO培养,感染相关的住院,成本和死亡.
- 在养老院,感染相关住院病例 (26.7%) 和费用 (26.8%) 显著下降.
结论:
- 一个区域解殖协作有效地减少了MDRO携带和相关感染.
- 这项干预措施对住院率,医疗费用和死亡率产生了积极影响.
- 这种方法突显了协调的区域感染控制战略的潜力.
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