在患者入院时,积极监测耐万科的Enterococcus faecium在爆发后
Kento Furuya1, Kyohei Sugiyama2, Kiyomi Suzuki3
1Department of Infection Control, Shizuoka General Hospital, Shizuoka, Japan; Department of Internal Medicine, Izu Redcross Hospital, Shizuoka, Japan; Department of Infectious Diseases, Graduate School of Medical Sciences, Nagoya City University, Aichi, Japan; Department of Infectious Diseases, Nagoya City University East Medical Center, Aichi, Japan.
概括
活性监测培养 (ASC) 针对抗万科胺素的Enterococcus faecium (VRE) 能够有效地识别疫情爆发后的高风险患者. 优先考虑那些先前检测到VRE或最近住院治疗的流行病地区的ASC可以改善查.
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
- 抗微生物耐药性 抗微生物耐药性
背景情况:
- 抗万科米辛的Enterococcus faecium (VRE) 由于高死亡率,对全球健康构成重大威胁.
- 积极监视文化 (ASC) 在入院时对VRE查的有效性仍然是争论的主题.
- 静岡總醫院 (SGH) 的醫院性VRE疫情需要對入院查策略進行評估.
研究的目的:
- 评估活跃监测培养 (ASC) 对于菌素耐药Enterococcus faecium (VRE) 在入院时的有效性.
- 为了确定高风险的患者群体,在医院疫情爆发后进行有针对性的VRE查.
主要方法:
- 在2023年1月至2023年12月期间,对高风险患者入院时进行VRE的活性监测培养 (ASC).
- 分析了与患者病史相关的ASC结果,包括VRE检测,最近在流行地区住院治疗和设备使用.
- 计算累积发病率和赔率比率 (ORs) 来确定阳性VRE ASC的风险因素.
主要成果:
- 在2941名查的患者中,13名 (0.44%) 检测出VRE病毒阳性.
- 具有先前VRE检测史的患者显示ASC阳性率最高 (27.78%,OR: 140.14).
- 最近在VRE流行地区住院 (5.88%,OR: 22.25) 和尿导管使用 (2.27%,OR: 6.51) 也与VRE检测增加有关.
结论:
- 住院时的积极监测培养 (ASC) 有效地识别了抗万素的Enterococcus faecium (VRE) 病例,特别是在疫情爆发后.
- 优先考虑VRE检测史或最近在VRE流行地区住院的患者.
- 有针对性的查策略可以优化资源分配,并加强医疗机构的VRE控制措施.
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