You Eunsung, Song Hyoyeop, Cho Jihyun, Lee Jaehoon
Department of Infection Control, Wonkwang University Hospital, Iksan, Republic of Korea.
Department of Internal Medicine, Wonkwang University College of Medicine, 344-2, Sinyong-dong, Iksan, 570-749, Republic of Korea.
Int J Infect Dis. 2014 May;22:9-10. doi: 10.1016/j.ijid.2014.01.011. Epub 2014 Feb 28.
A combination of infection control interventions, consisting of education, isolation, hand hygiene, contact precautions, and environmental disinfection, was implemented in the medical intensive care unit (MICU). The strict restriction of the use of antimicrobial agents was not included in this study. Following the interventions, the incidence of Clostridium difficile infection (CDI) in the MICU decreased significantly, by 67%, from 4.70 to 1.53 cases/1000 patient days (p = 0.012), while the hospital-wide incidence of CDI increased significantly from 0.93 to 1.17 cases/1000 patient-days (p = 0.021). A multifaceted approach to minimize C. difficile exposure can be effective in reducing the incidence of hospital-acquired CDI under conditions that do not allow for a restriction in the use of antimicrobial agents.
在医学重症监护病房(MICU)实施了包括教育、隔离、手部卫生、接触预防措施和环境消毒在内的综合感染控制干预措施。本研究未包括对抗菌药物使用的严格限制。干预措施实施后,MICU中艰难梭菌感染(CDI)的发生率显著下降,从4.70例/1000患者日降至1.53例/1000患者日,降幅为67%(p = 0.012),而全院范围内CDI的发生率则从0.93例/1000患者日显著增加至1.17例/1000患者日(p = 0.021)。在不允许限制抗菌药物使用的情况下,采取多方面措施尽量减少艰难梭菌暴露可有效降低医院获得性CDI的发生率。