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评估十二指镜相关殖民和十二指镜相关感染的风险:一项前性观察研究
K van der Ploeg1, C H W Klaassen2, S H J Renkens2
1Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
The Journal of hospital infection
|March 9, 2025
概括
在ERCP后,十二指镜相关殖民 (DAC) 和感染 (DAI) 的风险很低,即使是受污染的十二指镜. 常规监测和隔离协议似乎有效防止传播.
科学领域:
- 胃肠病学 胃肠病学
- 传染病流行病学 传染病流行病学
- 医疗器械安全 医疗器械安全
背景情况:
- 在ERCP中使用的十二指镜可能会受到污染,这可能会造成患者殖民和感染的潜在风险.
- 在ERCP手术后,十二指镜相关殖民 (DAC) 和感染 (DAI) 的实际发病率在很大程度上是未知的.
- 了解这种风险对于制定有效的预防和控制策略至关重要.
研究的目的:
- 在接受ERCP的患者中,前性评估十二指镜相关殖民 (DAC) 和感染 (DAI) 的发生率.
- 评估常规微生物监测和十二指镜检疫协议的有效性.
主要方法:
- 一项前性观察性研究,涉及2022年1月至2023年12月期间接受ERCP的成年患者.
- 在每次手术前都采用了十二指镜取样;污染是由肠道或口腔来源的微生物 (MGO) 的存在来定义的.
- 暴露于受污染的十二指镜的患者在ERCP后提供了便样本,并被跟踪了六个月,全基因组测序 (WGS) 用于确认.
主要成果:
- 在341个ERCP程序中,73个 (21.4%) 使用了MGO污染的十二指镜;没有爆发.
- 对六名患者的十二指镜患者的八对微生物的全基因组测序 (WGS) 分析显示,没有DAC或DAI的病例.
- 尽管有污染,但密集的患者监测并没有检测到DAC或DAI.
结论:
- 在没有疫情的环境中,有强有力的监测和隔离协议,在ERCP之后DAC和DAI的风险似乎很低.
- 这些发现表明,对DAC/DAI的密集患者监测可能具有有限的价值.
- 需要进一步的研究来证实这些结果,并确定DAC和DAI的特定风险因素.
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