在MDRO殖民患者中,侵入性MDRO感染的风险
Ali M Alshubaily1, Aeshah S Alosaimi2, Bushra I Alhothli3
1Pediatric Infectious Diseases Section, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Infection control and hospital epidemiology
|October 14, 2024
概括
与CRE,MRSA和VRE等多药耐药生物体 (MDRO) 结合殖民显著增加了感染风险. 对这些生物体的查可以指导高风险地区患者的治疗决策.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 流行病学 流行病学
背景情况:
- 多种耐药生物体 (MDROs),包括耐卡巴胺的肠杆菌 (CRE),耐甲基林的金黄色葡萄球菌 (MRSA) 和耐万素的肠球菌 (VRE) 构成了重大的医疗保健挑战.
- 了解从殖民到活跃感染的过渡对于有效的感染控制策略至关重要.
研究的目的:
- 为了估计在被殖民的患者中患上临床MDRO感染的风险,与进入高风险地区的非殖民患者相比.
- 特别关注CRE的殖民化和感染动态.
主要方法:
- 一个回顾性队列研究在一个三级护理机构进行.
- 分析了2021年接受CRE,MRSA或VRE主动监测测试 (AST) 的患者.
- 主要结局是AST结果后365天内发生侵袭性感染;风险比率计算以评估殖民和感染之间的关联.
主要成果:
- 总共分析了19134个AST.
- 殖民化与CRE (RR 4.6),MRSA (RR 8.2) 和VRE (RR 22) 的感染风险增加有显著关联.
- 在88%的CRE病例中,感染涉及在殖民期间发现的相同的碳酶基因,其中Oxa-48/NDM Klebsiella pneumoniae是最常见的.
结论:
- 对CRE,MRSA或VRE的殖民是这些病原体随后感染的确诊危险因素.
- 殖民和感染之间的遗传一致性表明,AST结果可以为MDROs的临床管理和治疗策略提供信息.
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