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欧洲通过人类源物质传播的细菌感染的优先排序。

Prioritizing of bacterial infections transmitted through substances of human origin in Europe.

作者信息

Domanović Dragoslav, Cassini Alessandro, Bekeredjian-Ding Isabelle, Bokhorst Arlinke, Bouwknegt Martijn, Facco Giuseppina, Galea George, Grossi Paolo, Jashari Ramadan, Jungbauer Christoph, Marcelis Jan, Raluca-Siska Ioana, Andersson-Vonrosen Inger, Suk Jonathan E

机构信息

European Centre for Disease Prevention and Control, Stockholm, Sweden.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.

出版信息

Transfusion. 2017 May;57(5):1311-1317. doi: 10.1111/trf.14036. Epub 2017 Feb 24.

Abstract

BACKGROUND

Bacteria are the pathogens most frequently transmitted through substances of human origin (SoHO). The European Centre for Disease Prevention and Control (ECDC) organized an expert consultation, with the objective of developing a priority list of bacterial pathogens transmissible via SoHO. The list will be used to further assess risks and determine appropriate preventive measures.

STUDY DESIGN AND METHODS

The 14 most frequently SoHO-transmitted bacteria identified through a scoping literature review were then prioritized during an expert workshop through a methodology based on multicriteria decision analysis. The selection of the prioritization method was based upon an ECDC framework for best practices in conducting risk-ranking exercises. Three transmission pathways, blood and blood components, tissues and cells, and organs, were considered in the ranking exercise.

RESULTS

According to the ranking score (RS), bacteria were organized within each SoHO pathway into one of four risk tiers: Tier 1 (RS ≥ 0.70), Tier 2 (RS = 0.60-0.69), Tier 3 (RS = 0.40-0.59), or Tier 4 (RS < 0.40). The most consistently identified pathogens in the highest risk Tiers 1 and 2 of all three pathways were: Staphylococcus aureus, Klebsiella spp., Escherichia coli, β-hemolytic streptococci, Pseudomonas spp., and Acinetobacter spp.

CONCLUSION

Six bacteria were defined as being of the highest priority in respect of the threat to the safety of SoHO and will be the subject of subsequent in-depth risk assessments to be conducted by ECDC to identify measures to mitigate the risk posed by these bacteria.

摘要

背景

细菌是最常通过人类源物质(SoHO)传播的病原体。欧洲疾病预防控制中心(ECDC)组织了一次专家咨询会,目的是制定一份可通过SoHO传播的细菌病原体优先清单。该清单将用于进一步评估风险并确定适当的预防措施。

研究设计与方法

通过范围界定文献综述确定的14种最常通过SoHO传播的细菌,随后在一次专家研讨会上,通过基于多标准决策分析的方法进行了优先排序。优先排序方法的选择基于ECDC进行风险排名活动的最佳实践框架。在排名活动中考虑了三种传播途径,即血液及血液成分、组织和细胞以及器官。

结果

根据排名分数(RS),细菌在每个SoHO途径内被分为四个风险等级之一:1级(RS≥0.70)、2级(RS = 0.60 - 0.69)、3级(RS = 0.40 - 0.59)或4级(RS < 0.40)。在所有三种途径的最高风险1级和2级中最一致确定的病原体是:金黄色葡萄球菌、克雷伯菌属、大肠杆菌、β溶血性链球菌、假单胞菌属和不动杆菌属。

结论

六种细菌被确定为对SoHO安全构成最高优先威胁,将成为ECDC随后进行深入风险评估的主题,以确定减轻这些细菌所构成风险的措施。

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