内镜逆行胰胆管造影术相关感染风险的管理：意大利地区层面的一项调查结果

The management of endoscopic retrograde cholangio- pancreatography-related infections risk: results of an italian survey at regional level.

作者信息

Cennamo V, Landi S, Aragona G, Colecchia A, Conigliaro R, Di Lorenzo D, Di Marco M, Fabbri C, Falcone P, Gaiani F, Manno M, Merighi A, Mussetto A, Peghetti A, Sassateli R, Solfrini V, Zagari R M, Arena R, Bertani H, Binda C, Boarino V, De Padova A, Feletti V, Fuccio L, Iori V, Nervi G, Prati G M, Soriani P, De Palma R

机构信息

Gastroenterology and Interventional Endoscopy Unit, Bellaria-Maggiore Hospital, AUSL of Bologna, Italy.

Department of Internal Medicine, Guglielmo da Saliceto Hospital, Piacenza, Italy.

出版信息

Ann Ig. 2023 Jan-Feb;35(1):84-91. doi: 10.7416/ai.2022.2518. Epub 2022 Apr 19.

DOI:10.7416/ai.2022.2518

PMID:35442386

Abstract

BACKGROUND AND AIM

Among the Endoscopic retrograde cholangiopancreatography (ERCP) adverse events, an increasingly arising problem is the transmission of Multi Drug Resistant (MDR) Bacteria through duodenoscopes. The aim of this survey was to evaluate the current clinical practice of management of ERCP associated infections in Emilia-Romagna, Italy.

METHODS

An online survey was developed including 12 questions on management of ERCP associated infections risk. The survey was proposed to all 12 endoscopy centers in Emilia Romagna that perform at least > 200 ERCPs per year.

RESULTS

11 centers completed the survey (92%). Among all risk factors of ERCP infections, hospitalization in intensive care units, immunosuppressant therapies, and previous MDR infections have achieved a 80 % minimum of concurrence by our respondents. The majority of them did not have a formalized document in their hospital describing categories and risk factors helpful in the detection of patients undergoing ERCP with an high-level infective risk (9/11, 82%). Most centers (8/11, 72%) do not perform screening in patients at risk of ERCP infections. Post procedural monitoring is performed by 6 of 11 centers (55%).

CONCLUSION

Our survey showed that, at least at regional level, there is a lack of procedures and protocols related to the management of patients at risk of ERCP infections.

摘要

背景与目的

在内镜逆行胰胆管造影术（ERCP）的不良事件中，一个日益突出的问题是多重耐药（MDR）细菌通过十二指肠镜传播。本次调查的目的是评估意大利艾米利亚 - 罗马涅地区ERCP相关感染管理的当前临床实践。

方法

开展了一项在线调查，包括12个关于ERCP相关感染风险管理的问题。该调查面向艾米利亚 - 罗马涅地区所有每年至少进行200例以上ERCP手术的12个内镜中心。

结果

11个中心完成了调查（92%）。在ERCP感染的所有风险因素中，重症监护病房住院、免疫抑制治疗和既往MDR感染在我们的受访者中至少有80%的一致性。其中大多数医院没有一份正式文件描述有助于检测具有高感染风险的ERCP患者的类别和风险因素（9/11，82%）。大多数中心（8/11，72%）不对ERCP感染风险患者进行筛查。11个中心中有6个（55%）进行术后监测。