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新型光动力涂层可减少患者附近表面的生物负荷,从而降低病原体传播的风险:两所医院的现场研究。

Novel photodynamic coating reduces the bioburden on near-patient surfaces thereby reducing the risk for onward pathogen transmission: a field study in two hospitals.

机构信息

University Medical Centre, Department of Dermatology, Regensburg, Germany.

University Medical Centre, Department of Infection Control and Infectious Diseases, Regensburg, Germany.

出版信息

J Hosp Infect. 2020 Jan;104(1):85-91. doi: 10.1016/j.jhin.2019.07.016. Epub 2019 Jul 29.

Abstract

BACKGROUND

Near-patient surfaces are recognized as a source for hospital-acquired infections. Such surfaces act as reservoirs for microbial contamination by which pathogens can be transmitted from colonized or infected patients to susceptible patients. Routine disinfection of surfaces only results in a temporal elimination of pathogens, and recontamination inevitably occurs shortly between disinfections.

AIM

A novel antimicrobial coating based on photodynamics was tested under laboratory conditions and subsequently in a field study in two hospitals under real-life conditions.

METHODS

Identical surfaces received a photodynamic or control coating. Bacterial counts [colony-forming units (cfu)/cm) were assessed regularly for up to 6 months.

FINDINGS

The laboratory study revealed a mean reduction of several human pathogens of up to 4.0 ± 0.3 log. The field study in near-patient environments demonstrated mean bacterial values of 6.1 ± 24.7 cfu/cm on all control coatings. Photodynamic coatings showed a significantly lower mean value of 1.9 ± 2.8 cfu/cm (P<0.001). When considering benchmarks of 2.5 cfu/cm or 5 cfu/cm, the relative risk for high bacterial counts on surfaces was reduced by 48% (odds ratio 0.38, P<0.001) or 67% (odds ratio 0.27, P<0.001), respectively.

CONCLUSION

Photodynamic coatings provide a significant and lasting reduction of bacterial counts on near-patient surfaces, particularly for high bacterial loads, in addition to routine hygiene. The promising results of this proof-of-concept study highlight the need for further studies to determine how this novel technology is correlated with the frequency of hospital-acquired infections.

摘要

背景

近患表面被认为是医院获得性感染的来源。这些表面是微生物污染的储存库,病原体可以通过这些污染从定植或感染的患者传播到易感患者。表面的常规消毒只会暂时消除病原体,在消毒之间不可避免地会再次污染。

目的

在实验室条件下和随后在两家医院的实地研究中,测试了一种基于光动力的新型抗菌涂层,在实际条件下进行了测试。

方法

相同的表面接受光动力或对照涂层。定期评估细菌计数[菌落形成单位(cfu)/cm)长达 6 个月。

发现

实验室研究显示,高达 4.0±0.3 对数的几种人类病原体的平均减少。在近患环境中的实地研究表明,所有对照涂层的平均细菌值为 6.1±24.7 cfu/cm。光动力涂层的平均细菌值明显较低,为 1.9±2.8 cfu/cm(P<0.001)。当考虑到 2.5 cfu/cm 或 5 cfu/cm 的基准时,表面高细菌计数的相对风险分别降低了 48%(优势比 0.38,P<0.001)或 67%(优势比 0.27,P<0.001)。

结论

光动力涂层可显著且持久地降低近患表面的细菌计数,尤其是对于高细菌负荷,除了常规卫生。这项概念验证研究的有希望结果突出表明需要进一步研究,以确定这种新技术如何与医院获得性感染的频率相关。

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