预防抗菌药物耐药和医源性感染的技术；2017 年日内瓦感染预防与控制-智库（第二部分）。
Technology for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva IPC-Think Tank (Part 2).
机构信息
Infection control programme and WHO collaborating center, University of Geneva Hospitals and Faculty of Medicine, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.
2US Centers for Disease Control and Prevention, Atlanta, GA USA.
出版信息
Antimicrob Resist Infect Control. 2019 May 22;8:83. doi: 10.1186/s13756-019-0538-y. eCollection 2019.
BACKGROUND
The high burden of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) is partially due to excessive antimicrobial use both in human and animal medicine worldwide. How can technology help to overcome challenges in infection prevention and control (IPC) and to prevent HAI and emerging AMR?
METHODS
In June 2017, 42 international experts convened in Geneva, Switzerland to discuss four potential domains of technology in IPC and AMR: 1) role and potential contribution of microbiome research; 2) whole genome sequencing; 3) effectiveness and benefit of antimicrobial environmental surfaces; and 4) future research in hand hygiene.
RESULTS
Research on the microbiome could expand understanding of antimicrobial use and also the role of probiotics or even faecal transplantation for therapeutic purposes. Whole genome sequencing will provide new insights in modes of transmission of infectious diseases. Although it is a powerful tool for public health epidemiology, some challenges with interpretation and costs still need to be addressed. The effectiveness and cost-effectiveness of antimicrobially coated or treated environmental high-touch surfaces requires further research before they can be recommended for routine use. Hand hygiene implementation can be advanced, where technological enhancement of surveillance, technique and compliance are coupled with reminders for healthcare professionals.
CONCLUSIONS
The four domains of technological innovation contribute to the prevention of HAI and AMR at different levels. Microbiome research may offer innovative concepts for future prevention, whole genome sequencing could detect new modes of transmission and become an additional tool for effective public health epidemiology, antimicrobial surfaces might help to decrease the environment as source of transmission but continue to raise more questions than answers, and technological innovation may have a role in improving surveillance approaches and supporting best practice in hand hygiene.
背景
全球范围内，医疗保健相关感染（HAI）和抗生素耐药性（AMR）负担沉重，这在一定程度上是由于人类和动物医学中抗生素的过度使用。技术如何帮助克服感染预防和控制（IPC）中的挑战，预防 HAI 和新兴的 AMR？
方法
2017 年 6 月，42 名国际专家在瑞士日内瓦召开会议，讨论 IPC 和 AMR 中四个潜在的技术领域：1）微生物组研究的作用和潜在贡献；2）全基因组测序；3）抗菌环境表面的有效性和益处；4）手卫生的未来研究。
结果
微生物组的研究可以扩展对抗生素使用的理解，也可以扩展对益生菌甚至粪便移植的治疗作用的理解。全基因组测序将为传染病的传播模式提供新的见解。尽管它是公共卫生流行病学的有力工具，但在解释和成本方面仍存在一些挑战需要解决。抗菌涂层或处理的环境高接触表面的有效性和成本效益需要进一步研究，然后才能推荐常规使用。在将技术增强监测、技术和合规性与医护人员的提醒相结合的情况下，可以推进手卫生的实施。
结论
技术创新的四个领域在不同层面上有助于预防 HAI 和 AMR。微生物组研究可能为未来的预防提供创新理念，全基因组测序可以检测新的传播模式，并成为有效的公共卫生流行病学的附加工具，抗菌表面可能有助于减少环境作为传播源，但仍存在更多问题而不是答案，技术创新可能在改进监测方法和支持最佳手部卫生实践方面发挥作用。
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