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氯己定浸渍擦布对降低血液肿瘤患者定植万古霉素耐药肠球菌的影响。

Impact of chlorhexidine-impregnated washcloths on reducing incidence of vancomycin-resistant enterococci colonization in hematology-oncology patients.

机构信息

Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, Victoria, Australia.

出版信息

Am J Infect Control. 2013 Apr;41(4):345-8. doi: 10.1016/j.ajic.2012.04.324. Epub 2012 Sep 11.

Abstract

BACKGROUND

Daily skin cleansing with washcloths impregnated with chlorhexidine gluconate (CHG) of patients in intensive care unit is associated with reduction in incidence of vancomycin-resistant Enterococci (VRE) acquisition. This study describes the impact on incidence of VRE colonization after the implementation of daily skin cleansing with 2% CHG-impregnated washcloths in hematology-oncology patients.

METHODS

In this before-and-after study, we compared the incidence rate of VRE colonization during the baseline period (where routine soap-and-water bathing was used) with the intervention period where patients were cleansed with 2% CHG-impregnated washcloths.

RESULTS

Acquisition of VRE decreased from 7.8% in the baseline to 3.8% in the intervention period (relative risk, 0.48, 95% confidence interval [CI], 0.21-1.09; P = .07). The crude relative rate of acquisition during the intervention period compared with the baseline period was 0.53 (95% CI, 0.23-1.23; P = .13). Patients who had been a roommate of a patient subsequently found to have VRE were at a significantly increased risk for acquiring VRE (hazard ratio, 18.8, 95% CI, 5.37-66.15; P < .001). However, patients admitted to the same bed number of previously known VRE-colonized patient were not at increased risk of VRE acquisition (hazard ratio, 0.37, 95% CI, 0.11-1.22; P = .10).

CONCLUSION

We did not observe a statistically significant reduction in the rate of VRE colonization in association with the use of 2% CHG-impregnated washcloths among hematology-oncology patients.

摘要

背景

重症监护病房(ICU)患者使用氯己定葡萄糖酸盐(CHG)浸渍的毛巾进行日常皮肤清洁可降低万古霉素耐药肠球菌(VRE)的获得率。本研究描述了在血液科-肿瘤患者中实施使用 2% CHG 浸渍毛巾进行日常皮肤清洁后,对 VRE 定植发生率的影响。

方法

在这项前后对照研究中,我们比较了基线期(常规使用肥皂和水沐浴)和干预期(患者使用 2% CHG 浸渍毛巾清洁)时 VRE 定植的发生率。

结果

VRE 的获得率从基线期的 7.8%降至干预期的 3.8%(相对风险,0.48;95%置信区间 [CI],0.21-1.09;P =.07)。与基线期相比,干预期获得 VRE 的粗相对率为 0.53(95% CI,0.23-1.23;P =.13)。与 VRE 患者有过室友关系的患者获得 VRE 的风险显著增加(风险比,18.8;95% CI,5.37-66.15;P <.001)。然而,入住先前已知 VRE 定植患者相同床位的患者获得 VRE 的风险并未增加(风险比,0.37;95% CI,0.11-1.22;P =.10)。

结论

我们没有观察到使用 2% CHG 浸渍毛巾与血液科-肿瘤患者中 VRE 定植率的降低之间存在统计学上的显著相关性。

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