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医疗保健相关性感染现患率调查及急性护理医院(PPS 2016-2017)和长期护理机构(HALT-3)中抗菌药物的使用:意大利中部莫利塞地区首次经验的综合报告,以及有针对性的干预策略。

Healthcare-associated infections point prevalence survey and antimicrobials use in acute care hospitals (PPS 2016-2017) and long-term care facilities (HALT-3): a comprehensive report of the first experience in Molise Region, Central Italy, and targeted intervention strategies.

机构信息

Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Italy.

Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Italy.

出版信息

J Infect Public Health. 2019 Jul-Aug;12(4):509-515. doi: 10.1016/j.jiph.2019.01.060. Epub 2019 Feb 7.

Abstract

BACKGROUND

Healthcare associated infections (HAIs) are a major public health concern both in acute hospitals and long-term care facilities (LTCFs), considering the clinical presentations and related costs. The study describes the first regional experience on HAIs and antimicrobials consumption obtained through point prevalence survey (PPS) 2016-2017 in the "Antonio Cardarelli" acute hospital, and in the LTCF of Larino municipality (Healthcare-associated infections and Antimicrobial use in European Long-Term care facilities, HALT-3) of Molise Region, Central Italy, both coordinated by the European Center for Disease Control (ECDC).

METHODS

PPS was carried out during 24-26 November 2016, while HALT-3 on 29 June 2017. Standardized protocols and software provided by ECDC were used to collect facilities information, patients/residents, HAIs and antibiotic consumption data.

RESULTS

An active HAI was found in 16 (7.1%) of 224 admitted patients in the acute hospital, and 50% occurred in a clinical specialty ward. Bundles, checklist for HAIs prevention and antimicrobial stewardship were lacking. Among 29 LTCF residents the HAIs prevalence was 3.4%. Surveillance programs for HAIs and antimicrobial stewardship strategy were not available.

CONCLUSION

The overall results identified the need and types of interventions to be implemented in both settings, either at organizational or individual level, to improve antibiotic prescription practice and limit risk factors involved in potentially preventable infections.

摘要

背景

医疗保健相关感染(HAIs)是急性医院和长期护理机构(LTCFs)中的一个主要公共卫生关注点,考虑到其临床表现和相关成本。该研究描述了通过 2016-2017 年在“Antonio Cardarelli”急性医院和意大利中部莫利塞地区拉利诺市 LTCF(欧洲疾病预防控制中心(ECDC)协调的欧洲卫生保健相关感染和抗生素使用在欧洲长期护理设施中,HALT-3)进行的点患病率调查(PPS)获得的关于 HAI 和抗生素消耗的首个区域性经验。

方法

PPS 于 2016 年 11 月 24 日至 26 日进行,而 HALT-3 于 2017 年 6 月 29 日进行。使用 ECDC 提供的标准化协议和软件收集设施信息、患者/居民、HAI 和抗生素消耗数据。

结果

在 224 名入住急性医院的患者中发现了 16 例(7.1%)活动性 HAI,其中 50%发生在临床专科病房。缺乏预防 HAI 的捆绑包、检查表和抗生素管理策略。在 29 名 LTCF 居民中,HAI 的患病率为 3.4%。未开展 HAI 监测计划和抗生素管理策略。

结论

总体结果确定了在这两种环境中需要实施的干预措施的类型,无论是在组织层面还是在个人层面,以改善抗生素处方实践并限制潜在可预防感染的危险因素。

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