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预防养老院中多重耐药菌的传播。

Prevention of the spread of multidrug-resistant organisms in nursing homes.

机构信息

Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy.

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

出版信息

Aging Clin Exp Res. 2021 Mar;33(3):679-687. doi: 10.1007/s40520-020-01746-2. Epub 2021 Jan 11.

Abstract

The increase in the aged population led to a global rise in the demand for elderly healthcare services, such as long-term care facilities (LTCFs), nursing homes, residential homes. Unfortunately, the spread of multidrug-resistant organisms (MDROs) in these structures represent an urgent public health threat requiring immediate action. The aim of this review is to provide a practice guide for the prevention of infections in European LTCFs. A team of experts identify specific problems and proposed practical solutions for the management of colonized and infected patients residing in LTCFs. The heterogeneity of LTCF represents one of the main problems for the implementation of standardized surveillance and infection control programs. Crucial steps involved in the spread of infections among LTCF residents are represented by patient's accommodation, MDRO screening on admission, management of patients with rectal colonization by MDROs, management of patients at high risk of MDRO infections, MDRO transmission by staff and implementation of antimicrobial stewardship. Efforts to implement specific actions in each of these fields are required to reduce the infections in this setting.

摘要

人口老龄化导致全球对老年医疗保健服务的需求增加,例如长期护理机构(LTCF)、养老院、安养院。不幸的是,这些机构中多药耐药菌(MDROs)的传播构成了紧迫的公共卫生威胁,需要立即采取行动。本综述的目的是为欧洲 LTCF 中的感染预防提供实践指南。一组专家确定了针对居住在 LTCF 中的定植和感染患者的管理的具体问题和实用解决方案。LTCF 的异质性是实施标准化监测和感染控制计划的主要问题之一。LTCF 居民之间感染传播的关键步骤包括患者的住宿、入院时的 MDRO 筛查、MDRO 定植患者的管理、MDRO 感染高风险患者的管理、员工 MDRO 传播以及抗菌药物管理的实施。需要在这些领域中的每一个都采取具体措施,以减少该环境中的感染。

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