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资源有限环境下麻醉医生手术室感染预防与控制的循证指南:系统评价/荟萃分析

Evidence-based guidelines on infection prevention and control in operation theatres for anesthetists in a resource-limited setting: systematic review/meta-analysis.

作者信息

Hailu Seyoum, Mulugeta Hailemariam, Girma Timsel, Asefa Amanuel, Regasa Teshome

机构信息

Department of Anesthesiology, Dilla University, Dilla, Ethiopia.

出版信息

Ann Med Surg (Lond). 2023 Apr 19;85(6):2858-2864. doi: 10.1097/MS9.0000000000000689. eCollection 2023 Jun.

Abstract

UNLABELLED

Surgical site infections and nosocomial infections are the most frequent source of prolonged hospital stay and cross-contamination of infection in the operating room. Despite the perception, the operating rooms are not sterile environments as it has sterile and nonsterile areas, as well as sterile and nonsterile personnel. The contaminated environment, like the anesthesia environment, is the most potent transmission vehicle for pathogens.

OBJECTIVE

The objective of this review is to develop evidence-based guidelines on infection prevention and control in operation theaters for anesthesia care providers in a resource-limited setting.

METHODOLOGY

This review is reported based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Articles published in the English language were searched from different sources to identify studies for the review using the keywords. Database search was done by using Boolean operators like AND, OR, NOT, or AND NOT from Cochrane review, Hinari, PubMed, Google Scholar, and Medline databases, and filtering was made based on the intervention, outcome, data on population, and methodological quality. The conclusion was made based on the level of evidence that was referred to by the Oxford Center for Evidence-Based Medicine.

RESULTS

Generally, 1672 articles were identified through database searching strategies. Articles were searched by filtering systems such as publication year, level of evidence, and duplicates that were unrelated to the topics. Finally, 20 articles (9 randomized controlled trials, 4 meta-analyses and systematic reviews, 4 reviews, and 3 observational studies) were identified by using keywords from different databases by different search strategies from 10 July to 14 August 2022.

CONCLUSION

As primary patient patrols anesthetists face significant infection risk and also contaminate the operating room environment. Precautions that are practical, affordable, and efficient in the anesthesia setting are needed considering the limited availability of personal protective equipment.

摘要

未标注

手术部位感染和医院感染是导致住院时间延长以及手术室感染交叉传播的最常见原因。尽管人们有这样的认知,但手术室并非无菌环境,因为它有无菌区和非无菌区,还有无菌人员和非无菌人员。像麻醉环境这样被污染的环境是病原体最强大的传播媒介。

目的

本综述的目的是为资源有限环境下的麻醉护理人员制定基于证据的手术室感染预防与控制指南。

方法

本综述依据系统评价和Meta分析的首选报告项目(PRISMA)方案进行报告。从不同来源搜索英文发表的文章,使用关键词来确定纳入综述的研究。通过使用布尔运算符(如AND、OR、NOT或AND NOT)在Cochrane综述、Hinari、PubMed、谷歌学术和Medline数据库中进行数据库搜索,并根据干预措施、结果、人群数据和方法学质量进行筛选。结论基于牛津循证医学中心所提及的证据水平得出。

结果

一般来说,通过数据库搜索策略共识别出1672篇文章。通过诸如发表年份、证据水平和与主题无关的重复文章等筛选系统对文章进行搜索。最后,在2022年7月10日至8月14日期间,通过不同搜索策略使用不同数据库中的关键词,确定了20篇文章(9项随机对照试验、4项Meta分析和系统评价、4篇综述以及3项观察性研究)。

结论

作为主要负责患者巡查的麻醉师面临着重大的感染风险,同时也会污染手术室环境。鉴于个人防护设备供应有限,需要在麻醉环境中采取切实可行、经济实惠且高效的预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6092/10289571/b3634996f322/ms9-85-2858-g001.jpg

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