一个多层次的感染控制干预对抗卡巴胺耐药的Acinetobacter baumannii获取:一个中断的时间序列
Daniel Grupel1, Abraham Borer2, Riki Yosipovich3
1Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Hebrew University, Jerusalem, Israel.
一个多层次的感染控制干预措施显著减少了内科病房的抗卡巴因耐药的Acinetobacter baumannii (CRAB) 感染. 这一策略甚至在高度依赖的非ICU设置中,在持续的CRAB传输中,也被证明是有效的.
科学领域:
- 传染性疾病 传染性疾病
- 医院流行病学 医院流行病学
- 公共卫生干预 公共卫生干预
背景情况:
- 耐卡巴胺的巴曼尼菌 (CRAB) 在医院环境中构成重大威胁.
- 限定的重症监护病房 (ICU) 床位往往导致CRAB患者在高依赖性 (HD) 非ICU内科病房 (IMW) 中得到管理.
- 在这些环境中持续的CRAB传播需要有效的感染控制策略.
研究的目的:
- 评估综合,多层次的感染控制干预措施的有效性.
- 评估对IMW中的CRAB感染率的影响,特别是非ICU的HD.
- 在现有CRAB传播的情况下,确定干预在现实世界的情景中的有效性.
主要方法:
- 采用了一种准实验性的,前后,中断时间序列研究设计.
- 一项为期3.5年的干预包括四个阶段:干预前,加强环境清洁,积极监测和CRAB阳性患者队列.
- 在整个研究期间,对照组的结果都得到了监测.
主要成果:
- 干预导致CRAB临床病例的显著减少,从干预前的平均0.89个减少到干预后的0.11个.
- 统计分析显示,干预后的斜率 (P = .02) 和水平 (P = .004) 发生了显著变化.
- 该研究涉及204名患者,平均年龄为69.8岁,出院后30天死亡率为55.9%.
结论:
- 一个多层次的感染控制策略,包括加强清洁,积极监测和患者队列,有效地减少了CRAB的获取.
- 该干预措施成功控制了内科病房和与之相关的非ICU内的CRAB传播.
- 这种方法为在资源有限的医院环境中管理CRAB提供了可行的解决方案.
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