Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Erciyes University, Kayseri, Turkey; European Study Group of Nosocomial Infections, Basel, Switzerland.
European Study Group of Nosocomial Infections, Basel, Switzerland; Division of Infection and Immunity, University College London, Gower Street, London, UK.
J Hosp Infect. 2019 Mar;101(3):248-256. doi: 10.1016/j.jhin.2018.07.022. Epub 2018 Jul 21.
In low- and middle-income countries (LMICs), the burden of healthcare-associated infections (HCAIs) is not known due to a lack of national surveillance systems, standardized infection definitions, and paucity of infection prevention and control (IPC) organizations and legal infrastructure.
To determine the status of IPC bundle practice and the most frequent interventional variables in LMICs.
A questionnaire was emailed to Infectious Diseases International Research Initiative (ID-IRI) Group Members and dedicated IPC doctors working in LMICs to examine self-reported practices/policies regarding IPC bundles. Responding country incomes were classified by World Bank definitions into low, middle, and high. Comparison of LMIC results was then made to a control group of high-income countries (HICs).
This survey reports practices from one low-income country (LIC), 16 middle-income countries (MICs) (13 European), compared to eight high-income countries (HICs). Eighteen (95%) MICs had an IPC committee in their hospital, 12 (63.2%) had an annual agreed programme and produced an HCAI report. Annual agreed programmes (87.5% vs 63.2%, respectively) and an annual HCAI report (75.0% vs 63.2%, respectively) were more common in HICs than MICs. All HICs had at least one invasive device-related surveillance programme. Seven (37%) MICs had no invasive device-related surveillance programme, six (32%) had no ventilator-associated pneumonia prevention bundles, seven (37%) had no catheter-associated urinary tract infection prevention bundles, and five (27%) had no central line-associated bloodstream infection prevention bundles.
LMICs need to develop their own bundles with low-cost and high-level-of-evidence variables adapted to the limited resources, with further validation in reducing infection rates.
在中低收入国家（LMICs），由于缺乏国家监测系统、标准化感染定义以及感染预防和控制（IPC）组织和法律基础设施，因此不知道与医疗保健相关的感染（HCAIs）的负担。
确定中低收入国家（LMICs）IPC 捆绑包实践的现状和最常见的干预变量。
向传染病国际研究倡议（ID-IRI）小组成员和在 LMICs 工作的专门 IPC 医生发送电子邮件调查问卷，以检查有关 IPC 捆绑包的自我报告实践/政策。根据世界银行的定义，将回复国家的收入分为低、中、高收入国家。然后将 LMIC 的结果与一组高收入国家（HICs）进行比较。
这项调查报告了一个低收入国家（LIC）和 16 个中低收入国家（MICs）（13 个欧洲国家）的实践情况，与 8 个高收入国家（HICs）进行了比较。18 个（95%）MICs 医院有 IPC 委员会，12 个（63.2%）有年度商定方案并制作了 HCAI 报告。年度商定方案（分别为 87.5%和 63.2%）和年度 HCAI 报告（分别为 75.0%和 63.2%）在 HICs 中比 MICs 更常见。所有 HICs 都至少有一个与侵入性设备相关的监测方案。7 个（37%）MICs 没有与侵入性设备相关的监测方案，6 个（32%）没有呼吸机相关性肺炎预防捆绑包，7 个（37%）没有导管相关性尿路感染预防捆绑包，5 个（27%）没有中心静脉导管相关血流感染预防捆绑包。
LMICs 需要根据有限的资源制定自己的捆绑包，使用低成本和高证据水平的变量，并进一步验证这些变量在降低感染率方面的效果。
