El Emam Khaled, Arbuckle Luk, Essex Aleksander, Samet Saeed, Eze Benjamin, Middleton Grant, Buckeridge David, Jonker Elizabeth, Moher Ester, Earle Craig
Electronic Health Information Laboratory, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Paediatrics, University of Ottawa, Ottawa, Ontario, Canada.
Electronic Health Information Laboratory, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
PLoS One. 2014 Apr 8;9(4):e93285. doi: 10.1371/journal.pone.0093285. eCollection 2014.
There is stigma attached to the identification of residents carrying antimicrobial resistant organisms (ARO) in long term care homes, yet there is a need to collect data about their prevalence for public health surveillance and intervention purposes.
We conducted a point prevalence study to assess ARO rates in long term care homes in Ontario using a secure data collection system.
All long term care homes in the province were asked to provide colonization or infection counts for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and extended-spectrum beta-lactamase (ESBL) as recorded in their electronic medical records, and the number of current residents. Data was collected online during the October-November 2011 period using a Paillier cryptosystem that allows computation on encrypted data.
A provably secure data collection system was implemented. Overall, 82% of the homes in the province responded. MRSA was the most frequent ARO identified at 3 cases per 100 residents, followed by ESBL at 0.83 per 100 residents, and VRE at 0.56 per 100 residents. The microbiological findings and their distribution were consistent with available provincial laboratory data reporting test results for AROs in hospitals.
We describe an ARO point prevalence study which demonstrated the feasibility of collecting data from long term care homes securely across the province and providing strong privacy and confidentiality assurances, while obtaining high response rates.
在长期护理机构中，识别携带抗菌药物耐药菌（ARO）的住客存在污名化现象，但出于公共卫生监测和干预目的，仍需要收集有关其流行率的数据。
我们开展了一项现患率研究，以使用安全的数据收集系统评估安大略省长期护理机构中的ARO感染率。
要求该省所有长期护理机构提供其电子病历中记录的耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）和超广谱β-内酰胺酶（ESBL）的定植或感染病例数，以及当前住客人数。2011年10月至11月期间，使用允许对加密数据进行计算的Paillier密码系统在线收集数据。
实施了一个可证明安全的数据收集系统。总体而言，该省82%的机构做出了回应。MRSA是最常见的ARO，每100名住客中有3例，其次是ESBL，每100名住客中有0.83例，VRE每100名住客中有0.56例。微生物学检查结果及其分布与该省医院报告的ARO检测结果的现有实验室数据一致。
我们描述了一项ARO现患率研究，该研究证明了在全省范围内从长期护理机构安全收集数据并提供强有力的隐私和保密保证，同时获得高回应率的可行性。
