使用修改定义在印度医院网络中对呼吸机相关肺炎的监测:试点研究
Purva Mathur1, Aparna Ningombam1, Kapil Dev Soni2
1Department of Laboratory Medicine, JPNATC, All India Institute of Medical Sciences, New Delhi, India.
这项研究为印度医院开发了一种修改的呼吸机相关肺炎 (VAP) 定义,发现Acinetobacter是最常见的病原体. 这一定义对于在低资源环境中准确的VAP监控至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 公共卫生监督 公共卫生监督
背景情况:
- 呼吸机相关的肺炎 (VAP) 在印度对患者的发病率和死亡率作出了重大贡献.
- 现有的通风器相关事件 (VAE) 监测标准在资源较少的环境中带来了挑战,可能导致报告不足.
- 为了可靠的负担估计,需要在多家医院之间制定标准化的VAP监控协议.
研究的目的:
- 开发和测试针对印度医疗保健设置量身定制的修改后的VAP定义.
- 适应现有的VAP监测标准,以在资源有限的环境中实现.
- 利用已建立的医疗保健相关感染 (HAI) 监测网络进行VAP监测.
主要方法:
- 在现有的HAI监控网络中,在13家医院进行了观察性试点研究.
- 开发了一个修改后的VAP定义,根据CDC的儿科VAP标准进行调整.
- 指定护士使用病例报告表格收集VAP事件和分母数据,并将其输入自定义数据库.
主要成果:
- 在40533个呼吸器日内,共记录了261个VAP事件,每1000个呼吸器日的VAP率为6.4.
- 这种细菌是Acinetobacter spp. (29.6%) 是最常见的生物体,其次是Klebsiella spp. (26.7%) 的情况.
- 在Acinetobacter spp.中观察到高水平的碳烯耐药性. (98%) 和肠道细菌 (85.5%).
结论:
- 修改后的VAP定义需要在更大的印度HAI监控网络中进行验证.
- 该协议的更广泛实施可以改善印度各地的VAP评估.
- 这项研究为在资源有限的环境中更准确的VAP监测提供了基础.
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