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超越个人防护设备:控制医源性呼吸道病毒感染的辅助方法。

Beyond personal protective equipment: adjunctive methods for control of healthcare-associated respiratory viral infections.

机构信息

Division of Infectious Disease, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

出版信息

Curr Opin Infect Dis. 2020 Aug;33(4):312-318. doi: 10.1097/QCO.0000000000000655.

Abstract

PURPOSE OF REVIEW

Prevention of nosocomial transmission of respiratory viruses is a priority in all healthcare settings and often achieved with the use of personal protective equipment. Several adjunctive infection prevention methods are in common use but their effectiveness in reducing healthcare-associated respiratory viral infections is unclear. In this review, recent advances regarding the effectiveness of several adjunctive infection prevention methods to reduce healthcare-associated respiratory viral infections are discussed.

RECENT FINDINGS

Training and education on hand hygiene guidelines, mandatory influenza vaccination for healthcare personnel, access to paid sick leave to reduce ill presenteeism, cohorting of patients with the same infection or clinical syndrome, neuraminidase inhibitor chemoprophylaxis during influenza outbreaks, and enhanced visitor restrictions in pediatric hospitals all have shown some degree of effectiveness in observational or quasi-experimental studies.

SUMMARY

Most of the studies evaluating the effect of adjunctive infection prevention methods on healthcare-associated respiratory viral infections are observational or quasi-experimental and are often combined with other interventions. Therefore, it is difficult to determine the precise effectiveness or efficacy of these interventions and more controlled trials are needed. Multimodal infection prevention policies are likely to be most effective in reducing healthcare-associated respiratory viral infections.

摘要

目的综述

预防医院内呼吸道病毒传播是所有医疗环境的重点,通常通过使用个人防护设备来实现。有几种辅助感染预防方法被广泛应用,但它们在减少医源性呼吸道病毒感染方面的有效性尚不清楚。在这篇综述中,讨论了最近在减少医源性呼吸道病毒感染方面,几种辅助感染预防方法的有效性的研究进展。

最近的发现

对手卫生指南的培训和教育、对医护人员进行强制性流感疫苗接种、提供带薪病假以减少因病缺勤、对具有相同感染或临床综合征的患者进行分组、在流感大流行期间使用神经氨酸酶抑制剂化学预防,以及在儿科医院加强访客限制,这些措施在观察性或准实验研究中都显示出了一定程度的有效性。

总结

评估辅助感染预防方法对医源性呼吸道病毒感染影响的大多数研究都是观察性或准实验性的,并且通常与其他干预措施结合进行。因此,很难确定这些干预措施的确切有效性,需要更多的对照试验。多模式感染预防策略可能是减少医源性呼吸道病毒感染最有效的方法。

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