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感染控制干预措施在减少医院环境中多重耐药菌传播的效果。

Efficacy of infection control interventions in reducing the spread of multidrug-resistant organisms in the hospital setting.

机构信息

Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America.

出版信息

PLoS One. 2012;7(2):e30170. doi: 10.1371/journal.pone.0030170. Epub 2012 Feb 20.

Abstract

Multidrug-resistant organisms (MDRO) continue to spread in hospitals globally, but the population-level impact of recommended preventive strategies and the relative benefit of individual strategies targeting all MDRO in the hospital setting are unclear. To explore the dynamics of MDRO transmission in the hospital, we develop a model extending data from clinical individual-level studies to quantify the impact of hand hygiene, contact precautions, reducing antimicrobial exposure and screening surveillance cultures in decreasing the prevalence of MDRO colonization and infection. The effect of an ongoing increase in the influx of patients colonized with MDRO into the hospital setting is also quantified. We find that most recommended strategies have substantial effect in decreasing the prevalence of MDRO over time. However, screening for asymptomatic MDRO colonization among patients who are not receiving antimicrobials is of minimal value in reducing the spread of MDRO.

摘要

多药耐药菌(MDRO)在全球医院继续传播,但推荐的预防策略对人群的影响以及针对医院中所有 MDRO 的个别策略的相对益处尚不清楚。为了探索医院中 MDRO 传播的动态,我们开发了一个模型,扩展了来自临床个体水平研究的数据,以量化手卫生、接触预防、减少抗菌药物暴露和筛查监测培养对降低 MDRO 定植和感染流行率的影响。还定量了不断增加的 MDRO 定植患者流入医院环境的影响。我们发现,大多数推荐的策略在降低 MDRO 流行率方面具有显著效果。然而,对未接受抗菌药物治疗的无症状 MDRO 定植患者进行筛查对于减少 MDRO 的传播几乎没有价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/243c/3282714/dd7add99d547/pone.0030170.g001.jpg

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