Enninger Anna, Schmidt Pia, Hasan Carola, Wager Julia, Zernikow Boris
Department of Children's Pain Therapy and Pediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany.
Pediatric Palliative Care Center and German Pediatric Pain Center, Children's and Adolescents' Hospital, Datteln, Witten/Herdecke University, Datteln, Germany.
J Palliat Med. 2021 Jan;24(1):122-132. doi: 10.1089/jpm.2019.0654. Epub 2020 Oct 20.
Multidrug-resistant organisms (MDROs) are an important health care issue. Patients in Western societies often present an increased morbidity of chronic conditions accompanied by poor immune status and the use of devices. In particular, patients in palliative care (PC) are at greater risk of MDRO colonization, due to accompanying special devices and being hospitalized. To gain an overview of the literature regarding MDROs in PC. : Systematic review : On the 19th of October 2019 the databases " PubMed" and " CINAHL" were used to identify studies reporting on MDROs in PC; the search was updated on 16th of May 2020. Seventeen out of 486 articles were included. Six represent qualitative data, 10 quantitative data, and one a mixed methods approach. Prevalence data range from 4.0% to 18%. MDRO colonization has a negative impact on patients and families. It leads to uncertainties and higher workload by staff members. Strategies for the management of MDROs in the field of PC are predominantly available for methicillin-resistant . Not even half of institutions utilize existing protocols. Recommendations for dealing with MDROs indicate required staff and time resources as well as information, communication, and specific knowledge. There is a great need for studies examining the prevalence of all MDROs in the PC setting. Additionally, not only patients but also a public enlightenment on MDROs should be provided to decrease knowledge gaps and therefore reduce transmission on MDROs.
多重耐药菌(MDROs)是一个重要的医疗保健问题。西方社会的患者往往慢性病发病率增加,同时免疫状况不佳且使用各种设备。特别是,姑息治疗(PC)患者由于使用特殊设备和住院,发生MDRO定植的风险更高。为了全面了解有关姑息治疗中MDROs的文献:系统评价:2019年10月19日,使用“PubMed”和“CINAHL”数据库识别报告姑息治疗中MDROs的研究;检索于2020年5月16日更新。486篇文章中有17篇被纳入。6篇代表定性数据,10篇代表定量数据,1篇采用混合方法。患病率数据范围为4.0%至18%。MDRO定植对患者和家庭有负面影响。它会导致不确定性,并增加工作人员的工作量。姑息治疗领域中MDROs的管理策略主要适用于耐甲氧西林菌。甚至不到一半的机构使用现有方案。应对MDROs的建议指出了所需的人员和时间资源以及信息、沟通和专业知识。非常需要开展研究,以调查姑息治疗环境中所有MDROs的患病率。此外,不仅应向患者,还应向公众普及MDROs知识,以缩小知识差距,从而减少MDROs的传播。