National Coordination Centre for Communicable Disease Control, RIVM-Centre for Communicable Diseases, Bilthoven, the Netherlands.
National Coordination Centre for Communicable Disease Control, RIVM-Centre for Communicable Diseases, Bilthoven, the Netherlands; Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, the Netherlands.
Clin Microbiol Infect. 2019 Mar;25(3):274-279. doi: 10.1016/j.cmi.2018.10.007. Epub 2018 Oct 26.
A comprehensive overview of the ways control measures directed at carriers of multidrug-resistant organisms (MDRO) affect daily life of carriers is lacking. In this systematic literature review, we sought to explore how carriers experience being a carrier and how they experience being subjected to control measures by looking at the impact on basic capabilities.
We searched Medline, Embase and PsychINFO until 26 May 2016 for studies addressing experiences of MDRO carriers. Twenty-seven studies were included, addressing experiences with methicillin-resistant Staphylococcus aureus (n = 21), ESBL (n = 1), multiple MDRO (n = 4) and other (n = 1, not specified). We categorized reported experiences according to Nussbaum's capability approach.
Carriage and control measures were found to interfere with quality of care, cause negative emotions, limit interactions with loved ones, cause stigmatization, limit recreational activities and create financial and professional insecurity. Further, carriers have difficulties with full comprehension of the problem of antimicrobial resistance, thus affecting six out of ten basic capabilities.
Applying Nussbaum's capability approach visualizes an array of unintended consequences of control measures. Carriers experience stigmatization, especially in healthcare settings, and have limited understanding of their situation and the complexities of antimicrobial resistance.
缺乏针对多重耐药菌（MDRO）携带者的控制措施如何影响携带者日常生活的全面概述。在这项系统文献综述中，我们试图通过观察对基本能力的影响，探讨携带者体验自身携带状态以及他们如何体验控制措施。
我们检索了 Medline、Embase 和 PsychINFO，截至 2016 年 5 月 26 日，以寻找针对 MDRO 携带者体验的研究。共纳入 27 项研究，涉及耐甲氧西林金黄色葡萄球菌（n=21）、ESBL（n=1）、多种 MDRO（n=4）和其他（n=1，未具体说明）。我们根据 Nussbaum 的能力方法对报告的经验进行了分类。
携带状态和控制措施被发现会干扰护理质量，引起负面情绪，限制与亲人的互动，导致污名化，限制娱乐活动并造成财务和职业不安全感。此外，携带者难以全面理解抗菌药物耐药问题，从而影响了十分之六的基本能力。
应用 Nussbaum 的能力方法可以直观地看到控制措施的一系列意外后果。携带者会经历污名化，尤其是在医疗保健环境中，并且对他们的情况和抗菌药物耐药的复杂性的理解有限。
