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[马医院的感染控制与卫生管理]

[Infection control and hygiene management in equine hospitals].

作者信息

Walther Birgit, Janssen Traute, Gehlen Heidrun, Vincze Szilvia, Borchers Kerstin, Wieler Lothar H, Barton Ann Kristin, Lübke-Becker Antina

出版信息

Berl Munch Tierarztl Wochenschr. 2014 Nov-Dec;127(11-12):486-97.

Abstract

With the rising importance of nosocomial infections in equine hospitals, increased efforts with regard to biosecurity and infection control are necessary. This even more since nosocomial infections are often associated with multi-drug resistant pathogens. Consequently, the implementation of targeted prevention programs is essential. Since nosocomial infections are usually multifactorial events, realization of only a single measure is rarely effective to overcome nosocomial spread in clinical practice. Equine patients may be colonized at admission with multi-drug resistant pathogens such as methicillin resistant Staphylococcus aureus (MRSA) and/or extended spectrum beta lactamase-producing (ESBL-) Enterobacteriaceae. Regardless of their individual resistance properties, these bacteria are common and usually unnoticed colonizers of either the nasopharynx or the intestinal tract. Also viral diseases caused by equine herpesvirus 1 (EHV-1) and EHV-4 may reach a clinic by patients which are latently infected or in the incubation period. To prevent nosocomal outbreaks, achieve an interruption in the infection chain and to eradicate infectious agents from the hospital environment, a professional hospital management is necessary. This should be adapted to both the wide range of pathogens causing nosocomial infections and the individual needs of equine patients. Amongst others, this approach includes a risk classification of equine patients at admission and information/enlightenment of the animal owners at discharge. An efficient management of inpatients, a targeted hygiene management and clear responsibilities with respect to biosecurity together with a surveillance of nosocomial infections form the cornerstone of infection control in equine hospitals.

摘要

随着医院感染在马医院中的重要性日益增加,有必要在生物安全和感染控制方面加大力度。鉴于医院感染通常与多重耐药病原体相关,这一点就显得尤为重要。因此,实施有针对性的预防计划至关重要。由于医院感染通常是多因素导致的事件,在临床实践中仅采取单一措施很少能有效遏制医院感染的传播。马患者在入院时可能已被多重耐药病原体定植,如耐甲氧西林金黄色葡萄球菌(MRSA)和/或产超广谱β-内酰胺酶(ESBL-)的肠杆菌科细菌。无论其个体耐药特性如何,这些细菌都是鼻咽部或肠道常见且通常未被注意到的定植菌。由马疱疹病毒1型(EHV-1)和EHV-4引起的病毒性疾病也可能通过潜伏感染的患者传入诊所。为防止医院感染暴发,中断感染链并从医院环境中根除传染源,专业的医院管理是必要的。这应适应导致医院感染的多种病原体以及马患者的个体需求。其中包括对马患者入院时进行风险分类,以及在出院时向动物主人提供信息/进行宣传。对住院患者进行有效管理、有针对性的卫生管理、明确生物安全方面的责任以及对医院感染进行监测,构成了马医院感染控制的基石。

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