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六年耐多药菌血症时间序列数据、医院抗生素使用和感染控制干预措施

Six-Year Time-Series Data on Multidrug-Resistant Bacteremia, Antibiotic Consumption, and Infection Control Interventions in a Hospital.

机构信息

Department of Clinical Pharmacology, Athens Medical Center, Athens, Greece.

Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece.

出版信息

Microb Drug Resist. 2022 Jul;28(7):806-818. doi: 10.1089/mdr.2022.0074.

Abstract

Multidrug-resistant (MDR) bacteremia is a serious health care-associated infection with significant morbidity and excess hospitalization costs. Our aim is to study the association between incidences of MDR bacteremia, antibiotic consumption, and infection control measures in a hospital from 2013 to 2018. We analyzed the following indices: (1) incidence of bacteremia (carbapenem-resistant , , and , methicillin-resistant , vancomycin-resistant ); (2) use of antibiotics; (3) consumption of disinfectant solutions for hand hygiene; and (4) isolation rates of MDR carrier patients. The use of advanced antibiotics ( = 0.001) and carbapenems ( = 0.008) decreased significantly in all hospital departments but the incidence of total MDR bacteremia did not change significantly. Increased use of hand disinfectant solutions was statistically associated with decreased incidence of total MDR bacteremia (incidence rate ratio [IRR]: 0.94, confidence interval [95% CI]: 0.90-0.99, : 0.020) in all hospital. Also, increased isolation rates of MDR carrier patients 2 months before correlated with decreased incidence of bacteremia due to carbapenem-resistant gram-negative pathogens (IRR: 0.35, 95% CI: 0.18-0.66, : 0.001) in adults intensive care unit. In our hospital, hand hygiene and isolation of MDR carrier patients controlled MDR bacteremia.

摘要

耐多药菌血症是一种严重的医疗相关感染,具有较高的发病率和住院费用。我们旨在研究 2013 年至 2018 年期间医院内耐多药菌血症的发生率、抗生素使用情况和感染控制措施之间的关系。我们分析了以下指标:(1)菌血症的发生率(耐碳青霉烯、耐、耐 、耐万古霉素);(2)抗生素的使用;(3)手部卫生用消毒剂的使用;(4)耐多药菌携带者的隔离率。所有医院科室中,高级抗生素( = 0.001)和碳青霉烯类药物( = 0.008)的使用显著减少,但总耐多药菌血症的发生率没有明显变化。手部消毒剂的使用增加与总耐多药菌血症的发生率呈统计学相关(发生率比 [IRR]:0.94,95%置信区间 [95% CI]:0.90-0.99,:0.020)。此外,2 个月前耐多药菌携带者的隔离率增加与成人重症监护病房耐碳青霉烯类革兰氏阴性病原体引起的菌血症发生率降低相关(IRR:0.35,95% CI:0.18-0.66,:0.001)。在我们医院,手部卫生和耐多药菌携带者的隔离控制了耐多药菌血症。

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