法国ICU的选择性消毒方案:与减少感染和耐药性的出现有关
Nicolas Massart1, Marc Leone2,3, Florian Reizine4
1Service de Réanimation Polyvalente, Centre Hospitalier de Saint Brieuc, CH de St BRIEUC, 10, Rue Marcel Proust, 22000, Saint-Brieuc, France. nicolasmassart@hotmail.fr.
Annals of intensive care
|March 25, 2025
概括
选择性去污染 (SD) 减少了在法国大型ICU网络中的ICU获得的感染和多耐药生物体 (MDRO) 殖民. SD实施没有影响ICU死亡率.
科学领域:
- 关键护理医学 关键护理医学
- 预防传染病 预防传染病
- 医疗卫生流行病学 医疗卫生流行病学
背景情况:
- 选择性去污染 (SD) 在减少ICU获得的感染方面表现有希望,但面临着较低的实施率.
- 本研究研究了SD的实施及其在法国大型重症监护室 (ICU) 网络中的影响.
研究的目的:
- 评估法国ICU网络中选择性消毒 (SD) 的实施情况.
- 评估SD对ICU获得感染率和多药耐药生物体 (MDRO) 殖民化的影响.
主要方法:
- 一个队列研究在该领域内.
- 这就是REA-REZOZO的意义.
- 监控网络涉及193个ICU.
- 分析了接受侵入性机械通风超过24小时的患者,将接受SD的组与标准护理 (SOC) 组进行比较.
- 使用倾向性得分匹配分析来比较结果,包括ICU获得感染的发病率和MDRO殖民率.
主要成果:
- 该研究包括81,661名患者,其中SD组有2,727名患者,SOC组有2,727名患者.
- 在SD组中,ICU获得的感染发病率明显较低 (发病率比=0.66;p<0.001).
- 在SD组中,多药耐药生物体 (MDROs) 的获取也显著减少 (1.5%与5.1%相比;p < 0.001),在ICU死亡率上没有显著差异.
结论:
- 选择性消毒 (SD) 策略与ICU获得感染率的显著减少有关.
- 实施SD有效地减少了ICU环境中多药耐药生物体 (MDROs) 的出现和获取.
- 虽然SD影响了感染和殖民率,但它似乎没有显著改变ICU死亡率.
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