耐万古霉素肠球菌引起医院获得性菌血症的时间聚集性及危险因素的识别
Identification of temporal clusters and risk factors of bacteremia by nosocomial vancomycin-resistant enterococci.
作者信息
da Silva Natal Santos, Muniz Vitor Dantas, Estofolete Cássia Fernanda, Furtado Guilherme Henrique Campos, Rubio Fernando Gongora
机构信息
Postgraduate Department, Medical College of São José do Rio Preto, São Paulo, Brazil; Medical Sciences Department, Medical College, Union of Colleges of the Great Lakes, São José do Rio Preto, São Paulo, Brazil.
Department of Infectious and Parasitic Diseases, Hospital de Base, São José do Rio Preto, São Paulo, Brazil.
出版信息
Am J Infect Control. 2014 Apr;42(4):389-92. doi: 10.1016/j.ajic.2013.11.010.
BACKGROUND
This study aimed to evaluate a different methodology for addressing the evolution of nosocomial bacteremia by vancomycin-resistant enterococci (VRE) in a hospital setting.
METHODS
In this retrospective cohort study, data were collected from the date of first registration up to December 2008 from the electronic medical records of patients with VRE bacteremia in a school hospital.
RESULTS
Thirty cases of VRE bacteremia and 274 cases of vancomycin-susceptible enterococci (VSE) bacteremia were identified. The average age of the patients was 56 years. The rates of Enterococcus faecium and Enterococcus faecalis in the hospital's intensive care unit (ICU) and wards showed no statistically significant differences. The risk of acquiring VRE bacteremia was at least 3-fold higher in the ICU than in the wards. The risk of death was 2.73-fold higher in patients with VRE bacteremia compared with those with VSE bacteremia. Only one temporal cluster statistically significant of VRE bacteremia was found in the study period.
CONCLUSIONS
The identification of temporal clusters can be an important tool to optimize health actions and thereby reduce the burden of operating costs.
背景
本研究旨在评估一种不同的方法，以应对医院环境中耐万古霉素肠球菌（VRE）引起的医院感染性菌血症的演变情况。
方法
在这项回顾性队列研究中，从一所学校医院的VRE菌血症患者的电子病历中收集了从首次登记日期到2008年12月的数据。
结果
共识别出30例VRE菌血症病例和274例万古霉素敏感肠球菌（VSE）菌血症病例。患者的平均年龄为56岁。医院重症监护病房（ICU）和病房中粪肠球菌和屎肠球菌的比例无统计学显著差异。在ICU中获得VRE菌血症的风险比在病房中至少高3倍。与VSE菌血症患者相比，VRE菌血症患者的死亡风险高2.73倍。在研究期间仅发现一个具有统计学意义的VRE菌血症时间聚集。
结论
识别时间聚集可以成为优化卫生行动从而降低运营成本负担的重要工具。
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