Muir Alison, Holden Christine, Sexton Elaine, Gray James W
Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK.
J Pediatr Gastroenterol Nutr. 2014 Aug;59(2):177-81. doi: 10.1097/MPG.0000000000000419.
Patients receiving home parenteral nutrition (HPN) are at particularly high risk of meticillin-sensitive Staphylococcus aureus (MSSA) catheter-related bloodstream infections (CRBSI). We developed a multidisciplinary enhanced care pathway encompassing a number of minimal cost interventions involving line/exit site care, training for staff and parents, multidisciplinary discharge planning, and monitoring compliance. Implementation reduced the mean rates of MSSA CRBSI (from 0.93, 95% CI 0.25-1.61, to 0.23, 95% CI -0.06 to 0.52, per 1000 parenteral nutrition [PN] days) and all-cause CRBSI (from 1.98, 95% CI 0.77-3.19, to 0.45, 95% CI 0.10-0.80, per 1000 PN days). A similar approach could be applied to preventing health care-associated infections in other complex, vulnerable patient groups.
接受家庭肠外营养（HPN）的患者发生甲氧西林敏感金黄色葡萄球菌（MSSA）导管相关血流感染（CRBSI）的风险特别高。我们制定了一条多学科强化护理路径，其中包括一些低成本干预措施，涉及管路/出口部位护理、对工作人员和家长的培训、多学科出院计划以及监测依从性。实施该路径后，MSSA CRBSI的平均发生率降低了（从每1000个肠外营养[PN]日0.93，95%置信区间0.25 - 1.61，降至0.23，95%置信区间 - 0.06至0.52），全因CRBSI的平均发生率也降低了（从每1000个PN日1.98，95%置信区间0.77 - 3.19，降至0.45，95%置信区间0.10 - 0.80）。类似的方法可应用于预防其他复杂、脆弱患者群体中的医疗保健相关感染。
