多步测试算法的影响 医院入院困难菌病率和临床结果
Matthew A Moffa1, Dustin R Carr2, Nathan R Shively1
1Medicine Institute and Division of Infectious Diseases, Allegheny Health Network, Pittsburgh, PA, USA.
概括
实施多步骤的Clostridioides difficile感染 (CDI) 测试算法显著降低了入院CDI的发生率. 这一变化没有对患者的临床结果产生负面影响,支持其在医疗保健机构的使用.
科学领域:
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
- 医疗保健管理的管理
背景情况:
- 艰难菌感染 (CDI) 在医疗保健环境中构成了重大挑战.
- 准确和高效的诊断方法对于管理CDI至关重要.
- 住院 (HO) -CDI率是感染控制的一个关键指标.
研究的目的:
- 评估多步CDI测试算法对HO-CDI速率的影响.
- 评估算法对患者临床结果的影响.
- 确定算法在临床决策和财务影响中的实用性.
主要方法:
- 在两个学术医院进行了一项回顾性干预前/干预后研究.
- 干预前期使用了独立的聚合酶连锁反应 (PCR) 试验.
- 干预后期实施了多步骤算法:积极的PCR试验被反射到谷氨酸脱酶抗原和毒素A/B酶免疫试验.
主要成果:
- 多步测试算法显著降低了HO-CDI比率,从每10,000个患者日的5.92降至2.36 (P<0.001).
- 在住院时间,ICU入院或治疗过程中没有发现显著差异.
- 所有原因的30天再接收显著下降,而CDI相关的再接收仍然相似.
结论:
- 一个多步骤的CDI测试算法有效地降低了HO-CDI率,而不会影响临床结果.
- 这种算法有助于医疗保健提供者管理CDI,并可能减轻财务处罚.
- 这些发现支持采用多步骤测试策略,以改善CDI监督和控制.
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