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在新生儿重症监护病房中对新生儿进行铜绿假单胞菌定植筛查是否有助于预防感染?

Does screening neonates in the neonatal intensive care unit for Pseudomonas aeruginosa colonization help prevent infection?

机构信息

Severn Pathology Infection Sciences, North Bristol NHS Trust, Bristol, UK.

Severn Pathology Infection Sciences, North Bristol NHS Trust, Bristol, UK.

出版信息

J Hosp Infect. 2018 Sep;100(1):54-59. doi: 10.1016/j.jhin.2018.06.019. Epub 2018 Jun 28.

Abstract

BACKGROUND

Pseudomonas aeruginosa (PA) is a Gram-negative environmental organism that can cause severe infection in immunosuppressed patients, including preterm neonates. In recent years, it has become common practice to screen neonates for PA colonization.

AIM

To assess the value of screening neonates for PA in (1) predicting the risk of developing severe PA infection and (2) directing infection control practice.

METHODS

Between August 2012 and September 2015, babies admitted to the neonatal intensive care unit (NICU) at North Bristol NHS Trust were screened routinely for PA colonization on admission and weekly thereafter. Data were also collected on babies who developed PA infection. Environmental samples from the NICU were tested for the presence of PA. Variable number tandem repeat (VNTR) typing was performed on all strains of PA from babies and the environment.

FINDINGS

No babies with positive screens subsequently developed PA infection. There was no VNTR strain evidence supporting cross-infection from the environment or other babies.

CONCLUSION

Screening neonates for PA did not identify babies who subsequently developed PA infection. Following cessation of screening in September 2015, there was no increase in the number of babies identified with PA infection.

摘要

背景

铜绿假单胞菌(PA)是一种革兰氏阴性环境生物体,可导致免疫功能低下的患者(包括早产儿)发生严重感染。近年来,对新生儿进行 PA 定植筛查已成为常规做法。

目的

评估对新生儿进行 PA 筛查(1)预测发生严重 PA 感染的风险,以及(2)指导感染控制实践的价值。

方法

2012 年 8 月至 2015 年 9 月,英国北布里斯托尔国民保健服务信托基金会的新生儿重症监护病房(NICU)对入院的新生儿常规进行 PA 定植筛查,此后每周进行一次筛查。还收集了发生 PA 感染的婴儿的数据。对 NICU 的环境样本进行了 PA 存在情况的检测。对来自婴儿和环境的所有 PA 菌株进行了可变数目串联重复(VNTR)分型。

结果

没有筛查阳性的婴儿随后发生 PA 感染。VNTR 菌株证据不支持环境或其他婴儿之间的交叉感染。

结论

对新生儿进行 PA 筛查并未发现随后发生 PA 感染的婴儿。2015 年 9 月停止筛查后,PA 感染婴儿的数量并未增加。

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