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囊性纤维化中的感染控制

Infection control in cystic fibrosis.

作者信息

Saiman Lisa, Siegel Jane

机构信息

Department of Pediatrics, Columbia University, New York, New York 10032, USA.

出版信息

Clin Microbiol Rev. 2004 Jan;17(1):57-71. doi: 10.1128/CMR.17.1.57-71.2004.

DOI:10.1128/CMR.17.1.57-71.2004
PMID:14726455
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC321464/
Abstract

Over the past 20 years there has been a greater interest in infection control in cystic fibrosis (CF) as patient-to-patient transmission of pathogens has been increasingly demonstrated in this unique patient population. The CF Foundation sponsored a consensus conference to craft recommendations for infection control practices for CF care providers. This review provides a summary of the literature addressing infection control in CF. Burkholderia cepacia complex, Pseudomonas aeruginosa, and Staphylococcus aureus have all been shown to spread between patients with CF. Standard precautions, transmission-based precautions including contact and droplet precautions, appropriate hand hygiene for health care workers, patients, and their families, and care of respiratory tract equipment to prevent the transmission of infectious agents serve as the foundations of infection control and prevent the acquisition of potential pathogens by patients with CF. The respiratory secretions of all CF patients potentially harbor clinically and epidemiologically important microorganisms, even if they have not yet been detected in cultures from the respiratory tract. CF patients should be educated to contain their secretions and maintain a distance of >3 ft from other CF patients to avoid the transmission of potential pathogens, even if culture results are unavailable or negative. To prevent the acquisition of pathogens from respiratory therapy equipment used in health care settings as well as in the home, such equipment should be cleaned and disinfected. It will be critical to measure the dissemination, implementation, and potential impact of these guidelines to monitor changes in practice and reduction in infections.

摘要

在过去20年里,囊性纤维化(CF)患者之间病原体传播的现象越来越多地被证实,因此人们对CF感染控制的关注度更高。CF基金会主办了一次共识会议,为CF护理人员制定感染控制措施建议。本综述总结了有关CF感染控制的文献。洋葱伯克霍尔德菌复合体、铜绿假单胞菌和金黄色葡萄球菌均已被证实在CF患者之间传播。标准预防措施、基于传播途径的预防措施(包括接触和飞沫预防措施)、医护人员、患者及其家属的适当手部卫生以及呼吸道设备的护理以防止传染源传播,是感染控制的基础,可防止CF患者感染潜在病原体。所有CF患者的呼吸道分泌物都可能携带具有临床和流行病学意义的微生物,即使在呼吸道培养物中尚未检测到。CF患者应接受教育,控制自己的分泌物,并与其他CF患者保持3英尺以上的距离,以避免潜在病原体的传播,即使培养结果未知或为阴性。为防止在医疗环境和家庭中使用的呼吸治疗设备传播病原体,此类设备应进行清洁和消毒。衡量这些指南的传播、实施情况及其潜在影响,对于监测实践变化和感染减少情况至关重要。

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