Olmedo María, Valerio Maricela, Reigadas Elena, Marín Mercedes, Alcalá Luis, Muñoz Patricia, Bouza Emilio
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
JAC Antimicrob Resist. 2020 Aug 11;2(3):dlaa037. doi: 10.1093/jacamr/dlaa037. eCollection 2020 Sep.
To evaluate the clinical impact of a bedside visit to patients with a positive test on the antimicrobial stewardship of infection (CDI) and non- infections.
All patients ≥18 years old with positive CDI laboratory tests hospitalized between January 2017 and August 2017 received an immediate bedside intervention that consisted mainly of checking protective measures and providing recommendations on infection control and the management of CDI and other infections.
A total of 214 patients were evaluated. The infectious disease (ID) physician was the first to establish protective measures in 25.2% of the cases. In 22/29 (75.9%) cases, physicians in charge accepted ID consultant recommendations to stop CDI treatment in asymptomatic patients. Unnecessary non-CDI antibiotics were discontinued in 19.1% of the cases. ID recommendations were not accepted by physicians in charge in only 12.6% of the cases.
A bedside rapid intervention for patients with a CDI-positive faecal sample was effective in avoiding overdiagnosis and unnecessary antibiotic treatment, optimizing anti-CDI drugs, increasing compliance with infection control measures and providing educational advice.
评估对粪便艰难梭菌感染（CDI）检测呈阳性的患者进行床边访视对CDI及非CDI抗菌药物管理的临床影响。
2017年1月至2017年8月期间住院的所有年龄≥18岁且CDI实验室检测呈阳性的患者均接受了即时床边干预，主要包括检查防护措施，并就感染控制以及CDI和其他感染的管理提供建议。
共评估了214例患者。在25.2%的病例中，传染病（ID）医生率先建立了防护措施。在22/29（75.9%）的病例中，主管医生接受了ID顾问关于停止对无症状患者进行CDI治疗的建议。19.1%的病例中停用了不必要的非CDI抗生素。仅12.6%的病例中主管医生未接受ID的建议。
对粪便CDI检测呈阳性的患者进行床边快速干预可有效避免过度诊断和不必要的抗生素治疗，优化抗CDI药物，提高对感染控制措施的依从性并提供教育建议。
