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[慕尼黑急症护理诊所中的多重耐药菌与艰难梭菌:临床常规数据现况调查结果]

[Multidrug-resistant organisms and C. difficile in Munich acute-care clinics: Results from a point prevalence study of clinical routine data].

作者信息

Hübner Nils-Olaf, Wegner Christian, Gleich Sabine

机构信息

Institut für Hygiene und Umweltmedizin, Projekt HICARE (Gesundheitsregion Ostseeküste), Universitätsmedizin Greifswald, Walther-Rathenau-Str. 49a, 17489, Greifswald, Deutschland.

IMD Labor Greifswald MVZ, Greifswald, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2015 Nov;58(11-12):1306-13. doi: 10.1007/s00103-015-2248-9.

Abstract

To combat multidrug resistant organisms (MRDOs), networks have been established all over Germany. Here we show here how those networks can survey the prevalence of MRDOs and C. difficile (CD), as well as structure data (e.g. staffing with hygiene control personnel), with reasonable efforts. We conducted a questionnaire-based point prevalence survey in May 2012. The prevalence (colonisation or infection) of inpatient cases with methicillin-resistant S. aureus (MRSA), vancomycin resistant S. aureus (VRSA), vancomycin resistant E. faecalis/E. faecium (VR-E. faecalis/VR-E. faecium), extended-spectrum-beta-lactamase-producing E. coli (ESBL-EC) and K. pneumoniae (ESBL-KP), multiresistant Acinetobacter spp. (MAB), multiresistant Pseudomonas spp. (MRP), carbapenemase-producing Enterobacteriaceae (CRE) as well as infections with Clostridium difficile (CD) were assessed. Out of 45 hospitals asked to participate, 89% sent back forms. Forms were filled out mostly by infection control personnel. In total 7154 patients were included. The most frequently reported MDROs were MRSA (prevalence: 1.37% of all included patients), ESBL-EC (1.12%), ESBL-KP (0.43%) and VRE (0.38%). VRSA and CRE were not reported. The prevalence of MRP (0.13%) and MAB (0.03%), was very low. The most frequently reported pathogen was CD (1.66%). Point prevalence surveys are a feasible way to gain regional data on the epidemiology of MDROs and to raise local awareness. Staffing with infection control personnel remains an issue, given the prevalence of nosocomial pathogens.

摘要

为对抗多重耐药菌(MRDOs),德国各地已建立起相关网络。在此我们展示这些网络如何以合理的工作量调查多重耐药菌和艰难梭菌(CD)的流行情况以及结构化数据(如配备卫生控制人员)。我们于2012年5月开展了一项基于问卷调查的现患率调查。评估了耐甲氧西林金黄色葡萄球菌(MRSA)、耐万古霉素金黄色葡萄球菌(VRSA)、耐万古霉素粪肠球菌/屎肠球菌(VR-E. faecalis/VR-E. faecium)、产超广谱β-内酰胺酶大肠杆菌(ESBL-EC)和肺炎克雷伯菌(ESBL-KP)、多重耐药不动杆菌属(MAB)、多重耐药铜绿假单胞菌属(MRP)、产碳青霉烯酶肠杆菌科细菌(CRE)的住院病例的流行情况(定植或感染)以及艰难梭菌(CD)感染情况。在被邀请参与的45家医院中,89%反馈了表格。表格大多由感染控制人员填写。总共纳入了7154名患者。报告最频繁的多重耐药菌是MRSA(流行率:占所有纳入患者的1.37%)、ESBL-EC(1.12%)、ESBL-KP(0.43%)和耐万古霉素肠球菌(0.38%)。未报告VRSA和CRE。MRP(0.13%)和MAB(0.03%)的流行率非常低。报告最频繁的病原体是CD(1.66%)。现患率调查是获取多重耐药菌流行病学区域数据并提高当地意识的可行方法。鉴于医院病原体的流行情况,配备感染控制人员仍是一个问题。

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