Division of Infectious Diseases, Department of Pediatrics, Columbia University, New York, NY 10032, USA.
Curr Opin Pulm Med. 2009 Nov;15(6):626-31. doi: 10.1097/MCP.0b013e328330d974.
This review will focus on recent research documenting baseline adherence to infection control recommendations and barriers to their implementation as experienced by multidisciplinary cystic fibrosis (CF) care providers. In addition, controversies regarding optimal infection control will be discussed. Finally, suggestions to improve infection control in CF will be proposed.
Compliance with recent guidelines was assessed for clinical microbiology laboratories and for infection control policies at CF care centers in the United States. Unlike earlier reports, the vast majority of laboratories used selective media for Burkholderia cepacia complex and identified all species of nonlactose fermenting Gram-negative bacilli. Fewer used selective media for Staphylococcus aureus or used agar-based susceptibility testing assays for Pseudomonas aeruginosa. Only 103 (65%) of 158 CF care centers provided written infection control policies for review and these were more likely to address inpatient than outpatient settings. Surveys of healthcare professionals showed that access to a copy of the CF infection control guidelines reduced barriers to adherence to selected infection control practices.
These data suggest that access to national infection control guidelines and written local policies are critically important to improving infection control for CF.
本篇综述将聚焦于最近的研究,记录多学科囊性纤维化(CF)护理提供者在遵循感染控制建议方面的基线依从性和实施过程中的障碍。此外,还将讨论关于最佳感染控制的争议。最后,将提出改善 CF 感染控制的建议。
对美国 CF 护理中心的临床微生物学实验室和感染控制政策进行了最近指南的依从性评估。与早期报告不同,绝大多数实验室使用选择性培养基来分离洋葱伯克霍尔德菌复合体,并鉴定所有非乳糖发酵革兰氏阴性杆菌。使用选择性培养基来分离金黄色葡萄球菌或使用琼脂基础药敏试验来分离铜绿假单胞菌的则较少。只有 158 个 CF 护理中心中的 103 个(65%)提供了书面感染控制政策供审查,而且这些政策更可能涉及住院患者而非门诊患者。对医疗保健专业人员的调查表明,获得 CF 感染控制指南的副本可以减少对某些感染控制措施的依从性障碍。
这些数据表明,获得国家感染控制指南和书面的本地政策对于改善 CF 的感染控制至关重要。