Yin Lijun, Wu Nana, Yan Gangfeng, Lu Lu, Qian Huimin, Yang Weijing, Ma Jian, He Leiyan, Lu Guoping, Zhai Xiaowen, Wang Chuanqing
Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China.
Department of Pediatric Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, China.
Heliyon. 2023 Aug 6;9(8):e18969. doi: 10.1016/j.heliyon.2023.e18969. eCollection 2023 Aug.
The increasing prevalence of carbapenem-resistant gram-negative bacilli infection has emerged as a substantial threat to human health.
In January 2017, a screening program for carbapenem-resistant gram-negative bacilli colonization was performed in a pediatric intensive care unit (PICU). Subsequently, different strategies for carbapenem-resistant gram-negative bacilli cohorting and patient placements were introduced in January 2018.
The increase in the single room isolation (type A) and the resettlement of the same area placement (type B) resulted in a significant decrease in the nosocomial infection rate from 2.57% (50/1945) in 2017 to 0.87% (15/1720) in 2021 ( < 0.001). Notably, the incidence of nosocomial carbapenem-resistant gram-negative bacilli infections decreased in 2019 ( = 0.046) and 2020 ( = 0.041) compared with that in the respective previous year. During 2019 and 2020, a statistically significant increasing trend of type A and type B placements was observed ( < 0.05, each), which may have contributed to the decline of carbapenem-resistant gram-negative bacilli infection. The primary carbapenemase genes identified in carbapenem-resistant isolates of and were from sequence type 11 and from sequence type 1712.
The integration of various placements for patients with carbapenem-resistant gram-negative bacilli infection with active screening has been demonstrated as an effective preventive strategy in the management of carbapenem-resistant gram-negative bacilli infection.
耐碳青霉烯类革兰氏阴性杆菌感染的日益流行已成为对人类健康的重大威胁。
2017年1月，在一家儿科重症监护病房（PICU）开展了耐碳青霉烯类革兰氏阴性杆菌定植筛查项目。随后，2018年1月引入了针对耐碳青霉烯类革兰氏阴性杆菌分组和患者安置的不同策略。
单人房间隔离（A型）的增加以及同一区域安置（B型）的重新安排导致医院感染率从2017年的2.57%（50/1945）显著降至2021年的0.87%（15/1720）（<0.001）。值得注意的是，与上一年相比，2019年（=0.046）和2020年（=0.041）医院耐碳青霉烯类革兰氏阴性杆菌感染的发生率有所下降。在2019年和2020年期间，观察到A型和B型安置有统计学上显著的上升趋势（均<0.05），这可能促成了耐碳青霉烯类革兰氏阴性杆菌感染的下降。在肺炎克雷伯菌和大肠埃希菌的耐碳青霉烯类分离株中鉴定出的主要碳青霉烯酶基因分别是序列类型11中的blaKPC和序列类型1712中的blaNDM。
已证明将耐碳青霉烯类革兰氏阴性杆菌感染患者的各种安置与主动筛查相结合是管理耐碳青霉烯类革兰氏阴性杆菌感染的有效预防策略。
