Field Epidemiology Training Programme, Public Health England, London, United Kingdom.
National Infection Service, Public Health England, London, United Kingdom.
Euro Surveill. 2021 Feb;26(8). doi: 10.2807/1560-7917.ES.2021.26.8.1900730.
Background is an emerging multidrug-resistant fungal pathogen associated with bloodstream, wound and other infections, especially in critically ill patients. carriage is persistent and is difficult to eradicate from the hospital environment.AimWe aimed to pilot admission screening for in intensive care units (ICUs) in England to estimate prevalence in the ICU population and to inform public health guidance.MethodsBetween May 2017 and April 2018, we screened admissions to eight adult ICUs in hospitals with no previous cases of in three major cities. Swabs were taken from the nose, throat, axilla, groin, perineum, rectum and catheter urine, then cultured and identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Patient records were linked to routine ICU data to describe and compare the demographic and health indicators of the screened cohort with a national cohort of ICU patients admitted between 2016 and 2017.ResultsAll screens for 921 adults from 998 admissions were negative. The upper confidence limit of the pooled prevalence across all sites was 0.4%. Comparison of the screened cohort with the national cohort showed it was broadly similar to the national cohort with respect to demographics and co-morbidities.ConclusionThese findings imply that colonisation among patients admitted to ICUs in England is currently rare. We would not currently recommend widespread screening for in ICUs in England. Hospitals should continue to screen high-risk individuals based on local risk assessment.
是一种新兴的、具有多重耐药性的真菌病原体，与血流感染、伤口感染和其他感染有关，尤其是在重症患者中。携带该病原体的情况持续存在，且难以从医院环境中根除。目的：我们旨在对英格兰的重症监护病房（ICU）进行 定植筛查，以估计 ICU 人群中的患病率，并为公共卫生指南提供信息。方法：在 2017 年 5 月至 2018 年 4 月期间，我们对三个主要城市的八家医院的成人 ICU 进行了筛查，这些医院之前没有 病例。从鼻腔、咽喉、腋窝、腹股沟、会阴、直肠和导尿管尿液中采集拭子，然后使用基质辅助激光解吸/电离飞行时间质谱（MALDI-TOF MS）进行培养和鉴定。患者记录与常规 ICU 数据相关联，以描述和比较筛查队列与 2016 年至 2017 年期间收治的 ICU 患者的全国性队列在人口统计学和健康指标方面的差异。结果：对 998 例住院患者中的 921 例进行的所有 筛查均为阴性。所有地点的汇总患病率上限为 0.4%。筛查队列与全国性队列的比较表明，在人口统计学和合并症方面，筛查队列与全国性队列基本相似。结论：这些发现表明，目前英格兰 ICU 患者中 定植的情况很少见。我们目前不会建议在英格兰的 ICU 中广泛筛查 。医院应继续根据当地风险评估对高危人群进行筛查。
