Barlow G, Sachdev N, Nathwani D
Infection and Immunodeficiency Unit, Kings Cross Hospital, Tayside University Hospitals NHS Trust, Dundee, UK.
J Hosp Infect. 2002 Feb;50(2):127-32. doi: 10.1053/jhin.2001.1138.
The emergence and re-emergence of communicable infections, especially those due to antibiotic resistant nosocomial pathogens, is likely to increase the burden on the limited isolation facilities of the UK. It was our perception, however, that isolation beds are not always used optimally; with patients requiring isolation sometimes being housed in open-bay beds, whilst other non-communicable patients are unnecessarily isolated. The main aim of this study was to test this hypothesis in a regional infectious diseases (ID) unit. A secondary aim was to provide useful data in the development of guidelines for the admission of patients to the new Dundee ID unit. One-third of patients (32% of all patients and 34% of total bed days) admitted to an isolation room in the current Dundee ID unit over a four-month period, were found to have low-risk or non-communicable conditions. In addition, 21 patients initially considered an infection risk, used 102 bed days following resolution of their infection. Evidence for the presence of patients with 'alert' infections housed in the open-bay beds of other wards, whilst low-risk or non-communicable patients are unnecessarily exposed to isolation in the ID unit, is presented. The findings suggest suboptimal use of the current Tayside University Hospitals' isolation facilities. Given the likelihood of high demand for the isolation of patients in the new Dundee ID unit, it is vital that these facilities are used appropriately, thereby minimizing the risk of nosocomial infection transmission and the unnecessary isolation of low-risk patients.
传染病的出现和再度出现，尤其是那些由耐抗生素的医院病原体引起的传染病，很可能会增加英国有限隔离设施的负担。然而，我们认为隔离床位并非总是得到最佳利用；有时需要隔离的患者被安置在开放式病房床位，而其他非传染病患者却被不必要地隔离。本研究的主要目的是在一个地区性传染病（ID）科室验证这一假设。次要目的是为制定新的邓迪ID科室患者收治指南提供有用数据。在四个月的时间里，入住当前邓迪ID科室隔离病房的患者中有三分之一（占所有患者的32%和总住院天数的34%）被发现患有低风险或非传染性疾病。此外，21名最初被认为有感染风险的患者在感染消除后使用了102个住院日。本文还提供了证据，表明其他病房开放式床位收治了患有“警戒”感染的患者，而低风险或非传染性患者却在ID科室被不必要地暴露于隔离环境中。研究结果表明泰赛德大学医院目前的隔离设施使用欠佳。鉴于新的邓迪ID科室对患者隔离的需求可能很高，至关重要的是要恰当地使用这些设施，从而将医院感染传播的风险和低风险患者不必要的隔离降至最低。
