VA Ann Arbor Center for Clinical Management Research and Medicine Service, VA Ann Arbor Healthcare System, and.
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.
Clin Infect Dis. 2017 May 15;64(suppl_2):S105-S111. doi: 10.1093/cid/cix073.
Numerous evidence-based practices for preventing device-associated infections are available, yet the extent to which these practices are regularly used in acute care hospitals across different countries has not been compared, to our knowledge.
Data from hospital surveys conducted in Japan, the United States, and Thailand in 2012, 2013, and 2014, respectively, were evaluated to determine the use of recommended practices to prevent central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI). The outcomes were the percentage of hospitals reporting regular use (a score of 4 or 5 on a scale from 1 [never use] to 5 [always use]) of each practice across countries and identified hospital characteristics associated with the use of selected practices in each country.
Survey response rates were 71% in Japan and the United States and 87% in Thailand. A majority of hospitals in Japan (76.6%), Thailand (63.2%), and the United States (97.8%) used maximum barrier precautions for preventing CLABSI and semirecumbent positioning to prevent VAP (66.2% for Japan, 86.7% for Thailand, and 98.7% for the United States). Nearly all hospitals (>90%) in Thailand and the United States reported monitoring CLABSI, VAP, and CAUTI rates, whereas in Japan only CLABSI rates were monitored by a majority of hospitals. Regular use of CAUTI prevention practices was variable across the 3 countries, with only a few practices adopted by >50% of hospitals.
A majority of hospitals in Japan, Thailand, and the United States have adopted certain practices to prevent CLABSI and VAP. Opportunities for targeting prevention activities and reducing device-associated infection risk in hospitals exist across all 3 countries.
有许多循证医学实践可用于预防器械相关感染，然而，据我们所知，这些实践在不同国家的急性护理医院中被常规使用的程度尚未进行比较。
评估了分别于 2012 年、2013 年和 2014 年在日本、美国和泰国进行的医院调查数据，以确定预防中心静脉导管相关血流感染（CLABSI）、呼吸机相关性肺炎（VAP）和导管相关尿路感染（CAUTI）的推荐实践的使用情况。结果是报告在各国定期使用（1[从不使用]至 5[始终使用]的评分范围为 4 或 5）的医院比例，以及与每个国家中选定实践的使用相关的医院特征。
日本和美国的调查回复率分别为 71%和 87%，泰国为 87%。日本（76.6%）、泰国（63.2%）和美国（97.8%）的大多数医院都采用了最大屏障预防措施来预防 CLABSI 和半卧位预防 VAP（日本 66.2%、泰国 86.7%和美国 98.7%）。泰国和美国的几乎所有医院（>90%）都报告了 CLABSI、VAP 和 CAUTI 率的监测，而日本只有大多数医院监测 CLABSI 率。在这 3 个国家中，CAUTI 预防实践的定期使用情况各不相同，只有少数实践被超过 50%的医院采用。
日本、泰国和美国的大多数医院都采用了某些预防 CLABSI 和 VAP 的措施。在所有 3 个国家中，都有针对预防活动和降低器械相关感染风险的机会。
