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耐甲氧西林糖尿病足交叉感染:一例报告

Methicillin-Resistant Diabetic Foot Crossed Infection: A Case Report.

作者信息

Reina-Bueno María, Palomo-Toucedo Inmaculada C, Castro-Méndez Aurora, Domínguez-Maldonado Gabriel, Vázquez-Bautista María Del Carmen

机构信息

Department of Podiatry, University of Seville, 41009 Seville, Spain.

出版信息

Pathogens. 2020 Jul 8;9(7):549. doi: 10.3390/pathogens9070549.

Abstract

This work presents a protocol to prevent the transmission of multidrug-resistant infections. We focus on the Diabetic Foot Unit Podiatry Clinic Area attached to the University of Seville in particular. The most common complication for patients with diabetes is leg ulcers. Together with neuropathy, vasculopathy, and immunological response disorder, these individuals have a high predisposition to developing infections. Staphylococcus aureus is a highly prevalent microorganism in humans which, at times, may act as a pathogen. Due mainly to indiscriminate abuse of antibiotics, the methicillin-resistant strain known by its initials as MRSA is the most extended nosocomial infection globally and is a severe community and hospital healthcare problem. This paper describes compliance with new general recommendations on cleaning, hygiene, and decontamination, in addition to implementation of this specific protocol, after detection of cross infection (healthcare-related infection) in the studied unit in two patients with MRSA-infected ulcers. After an in-depth bibliographical review, strict hand hygiene measures and use of non-sterile gloves were used when treating all patients with a diabetic foot. Finally, we reflect on the need to educate healthcare personnel to guarantee correct prescription of selected antibiotics. The role of the podiatrist in the multidisciplinary team is highlighted not only in terms of management and treatment of lesions in diabetic patients, but also as a healthcare agent for the detection and prevention of MRSA together with other multidrug-resistant infections.

摘要

这项工作提出了一种预防多重耐药感染传播的方案。我们特别关注塞维利亚大学附属的糖尿病足病科足病诊所区域。糖尿病患者最常见的并发症是腿部溃疡。这些患者除了患有神经病变、血管病变和免疫反应紊乱外,还极易发生感染。金黄色葡萄球菌是人类中高度流行的微生物,有时可能会成为病原体。主要由于抗生素的滥用,以首字母缩写MRSA闻名的耐甲氧西林菌株是全球范围内最广泛传播的医院感染病原体,也是社区和医院医疗保健中的一个严重问题。本文描述了在研究单元中两名患有MRSA感染溃疡的患者检测到交叉感染(医疗相关感染)后,除了实施该特定方案外,还遵守了关于清洁、卫生和去污的新一般建议。经过深入的文献综述,在治疗所有糖尿病足患者时采取了严格的手部卫生措施并使用了非无菌手套。最后,我们思考了对医护人员进行教育以确保正确选用抗生素的必要性。足病医生在多学科团队中的作用不仅体现在糖尿病患者病变的管理和治疗方面,还体现在作为检测和预防MRSA以及其他多重耐药感染的医疗保健人员方面。

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