Pawlak Maria, Lewtak Katarzyna, Nitsch-Osuch Aneta
Department of Social Medicine and Public Health, Medical University of Warsaw, Faculty of Medicine, Warsaw, Poland.
Can J Infect Dis Med Microbiol. 2022 Apr 26;2022:9299258. doi: 10.1155/2022/9299258. eCollection 2022.
The objective of this study was to evaluate the effectiveness of hospital-based antiepidemic measures aimed at limiting the spread of symptomatic infections and colonization with carbapenem-resistant (CPE), mainly NDM-producing , with particular emphasis on microbiological screening tests.
This retrospective study was based on data from 168 hospitals under the supervision of the Provincial Sanitary and Epidemiological Station in Warsaw, Poland, in 2016-2017. Analysis of the effectiveness of antiepidemic procedures focused on the type of implemented antiepidemic procedures, the number of microbiological screening tests per year, the geographic location of the hospitals (inside or outside Warsaw), the timing of the screening tests (on admission to hospital or 48 hours later), and the results of the screening tests.
Rates of proper isolation of patients infected or colonized with an alarm pathogen including NDM-producing increased from 38.0% in 2016 to 49.5% in 2017 ( > 0.05). The number of screening tests performed increased by 88% from 68319 in 2016 to 128373 in 2017. The number of epidemic outbreaks of symptomatic infections caused by NDM-producing decreased from 11 in 2016 to 7 in 2017 in hospitals in Warsaw, where microbiological screening tests were performed. The number of outbreaks in hospitals outside Warsaw, where the screening tests were not performed or were limited, increased from 8 in 2016 to 24 in 2017.
Screening tests increase the chance of detecting colonization by CPE. The implementation of microbiological screening decreased the risk of epidemic outbreaks of symptomatic infections caused by CPE.
本研究的目的是评估以医院为基础的抗疫措施的有效性，这些措施旨在限制有症状感染的传播以及耐碳青霉烯类肠杆菌科细菌（CPE）（主要是产新德里金属β-内酰胺酶[NDM]的细菌）的定植，特别强调微生物筛查检测。
这项回顾性研究基于2016 - 2017年波兰华沙省卫生和流行病学站监督下的168家医院的数据。对抗疫程序有效性的分析集中在实施的抗疫程序类型、每年微生物筛查检测的数量、医院的地理位置（华沙市内或市外）、筛查检测的时间（入院时或48小时后）以及筛查检测的结果。
感染或定植有包括产NDM细菌在内的警示病原体的患者的正确隔离率从2016年的38.0%上升至2017年的49.5%（P>0.05）。进行的筛查检测数量从2016年的68319次增加了88%，至2017年的128373次。在进行微生物筛查检测的华沙医院中，由产NDM细菌引起的有症状感染的疫情暴发数量从2016年的11起降至2017年的7起。在未进行或仅进行有限筛查检测的华沙以外医院，疫情暴发数量从2元16年的8起增至2017年的24起。
筛查检测增加了检测到CPE定植的机会。微生物筛查的实施降低了由CPE引起的有症状感染的疫情暴发风险。
