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在医院建筑施工期间,环境控制措施降低急性白血病患者侵袭性曲霉病风险的有效性。

Effectiveness of environmental control measures to decrease the risk of invasive aspergillosis in acute leukaemia patients during hospital building work.

作者信息

Combariza J F, Toro L F, Orozco J J

机构信息

Hospital Pablo Tobón Uribe, Medellin, Antioquia, Colombia.

Universidad CES, Medellín, Antioquia, Colombia.

出版信息

J Hosp Infect. 2017 Aug;96(4):336-341. doi: 10.1016/j.jhin.2017.04.022. Epub 2017 May 5.

DOI:10.1016/j.jhin.2017.04.022
PMID:28545828
Abstract

BACKGROUND

Invasive aspergillosis (IA) is a significant problem in acute leukaemia patients. Construction work near hospital wards caring for immunocompromised patients is one of the main risk factors for developing invasive pulmonary aspergillosis (IPA).

AIM

To assess the impact of environmental control measures used during hospital construction for the prevention of IA in acute leukaemia patients.

METHODS

A retrospective cohort study was developed to evaluate the IA incidence in acute leukaemia patients with different environmental control measures employed during hospital construction. We used European Organisation for the Research and Treatment of Cancer (EORTC) criterial diagnosis parameters for definition of IA.

FINDINGS

A total of 175 episodes of inpatient care were evaluated, 62 of which did not have any environmental control measures (when an outbreak occurred), and 113 that were subject to environmental control measures directed to preventing IA. The study showed an IA incidence of 25.8% for the group without environmental control measures vs 12.4% for those who did receive environmental control measures (P=0.024). The relative risk for IA was 0.595 (95% confidence interval: 0.394-0.897) for the group with environmental control measures.

CONCLUSION

The current study suggests that the implementation of environmental control measures during a hospital construction has a positive impact for prevention of IA in patients hospitalized with acute leukaemia.

摘要

背景

侵袭性曲霉病(IA)在急性白血病患者中是一个重大问题。在收治免疫功能低下患者的医院病房附近进行建筑施工是发生侵袭性肺曲霉病(IPA)的主要危险因素之一。

目的

评估医院建设期间采用的环境控制措施对预防急性白血病患者发生IA的影响。

方法

开展一项回顾性队列研究,以评估在医院建设期间采用不同环境控制措施的急性白血病患者的IA发病率。我们使用欧洲癌症研究与治疗组织(EORTC)的标准诊断参数来定义IA。

结果

共评估了175例住院护理事件,其中62例(在暴发期间)未采取任何环境控制措施,113例采取了针对预防IA的环境控制措施。研究表明,未采取环境控制措施的组IA发病率为25.8%,而采取了环境控制措施的组为12.4%(P = 0.024)。采取环境控制措施的组IA的相对风险为0.595(95%置信区间:0.394 - 0.897)。

结论

当前研究表明,医院建设期间实施环境控制措施对预防急性白血病住院患者发生IA有积极影响。

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