a Evidence Based Child Health Group, Division of Child Health , Obstetrics & Gynaecology, Queens Medical Centre , Nottingham , UK.
Expert Rev Respir Med. 2019 May;13(5):425-434. doi: 10.1080/17476348.2019.1595594. Epub 2019 Mar 26.
Cystic fibrosis is a life-limiting genetic condition characterized by recurrent pulmonary infection. Acquisition of infection can occur from environmental reservoirs, person-to-person transmission and from the healthcare environment. Primary prevention of infections through infection prevention and control measures is an important strategy in cystic fibrosis care. Areas covered: Here we present a systematic review of the evidence base around infection prevention and control in cystic fibrosis. We found 36 studies and 7 guidelines that met our inclusion criteria. Strategies covered include cohort segregation, individual segregation, hand hygiene, facemasks, combination strategies, equipment strategies, and adherence. Quality of evidence overall was deemed low or very low. Most guideline recommendations have little or no evidence to support them. Expert opinion: Although low quality, there is an abundance of evidence suggesting segregation is beneficial in reducing pathogen spread. Undertaking high-quality studies may, therefore, be ethically challenging. Large-scale registry studies may provide a better strategy for answering questions on the efficacy of infection control policy. With the rise of antibiotic resistance, effective eradication of cystic fibrosis pathogens is becoming more difficult so primary prevention through infection control will become increasingly important over the coming years.
囊性纤维化是一种具有生命限制的遗传疾病，其特征是反复发生肺部感染。感染的获得可能来自环境储层、人际传播和医疗保健环境。通过感染预防和控制措施进行感染的初级预防是囊性纤维化护理的重要策略。
在这里，我们对囊性纤维化感染预防和控制的证据基础进行了系统回顾。我们发现了 36 项研究和 7 项符合纳入标准的指南。涵盖的策略包括队列隔离、个体隔离、手卫生、口罩、联合策略、设备策略和依从性。总体证据质量被认为是低或极低。大多数指南建议几乎没有或没有证据支持。
尽管质量较低，但有大量证据表明隔离有助于减少病原体的传播。因此，进行高质量的研究可能在伦理上具有挑战性。大规模登记研究可能为回答有关感染控制政策效果的问题提供更好的策略。随着抗生素耐药性的出现，有效根除囊性纤维化病原体变得越来越困难，因此在未来几年，通过感染控制进行初级预防将变得越来越重要。
