Ji Binghui, Ye Weijiang
Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China.
The Rehabilitation Hospital of the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Medicine (Baltimore). 2024 Jan 26;103(4):e37018. doi: 10.1097/MD.0000000000037018.
Multidrug-resistant is defined as nonsusceptibility to at least 1 agent in 3 or more antimicrobial categories. Controlling the spread of drug-resistant organisms is a key step in the management of hospital-acquired infections (HAIs). To review the progress of research on the prevention and control of HAIs with multidrug-resistant organism (MDRO) in the past 5 years, and to provide reference for the development of comprehensive measures for the prevention and control of HAIs with MDRO. We conducted a search in the PUBMED database for studies related to MDRO and HAIs from 2018 to 2023, then integrated this data with information sourced from the U.S.A. The Centers for Disease Control and Prevention. Utilizing information technology to monitor and provide feedback on hand hygiene practices can enhance compliance. Environmental disinfection techniques such as ultraviolet or hydrogen peroxide demonstrate potential in reducing MDRO transmission. While some studies support that contact isolation measures for MDRO-infected or colonized patients can reduce HAIs, others do not confirm this outcome. Approaches for MDRO colonization among patients or physicians may mitigate MDRO transmission risk. Implementing clusterization interventions proves to enhance efficiency and cost-effectiveness in preventing and controlling MDRO. Early screening for pathogen species emerges as a valuable strategy aiding in antimicrobial use control. Combined with evidence from the literature, implementing clusterization interventions that include measures such as monitoring and feedback on hand hygiene and improved environmental disinfection techniques can help prevent and control HAIs with MDRO. However, further clinical studies are needed to validate the optimal clusterization intervention.
多重耐药性被定义为对3种或更多抗菌药物类别中的至少1种药物不敏感。控制耐药菌的传播是医院获得性感染(HAIs)管理中的关键一步。回顾过去5年多重耐药菌(MDRO)医院获得性感染防控研究进展,为制定MDRO医院获得性感染综合防控措施提供参考。我们在PUBMED数据库中检索了2018年至2023年与MDRO和HAIs相关的研究,然后将这些数据与来自美国疾病控制与预防中心的信息相结合。利用信息技术监测并对手卫生习惯提供反馈可提高依从性。紫外线或过氧化氢等环境消毒技术在减少MDRO传播方面显示出潜力。虽然一些研究支持对MDRO感染或定植患者采取接触隔离措施可减少HAIs,但其他研究并未证实这一结果。针对患者或医护人员中MDRO定植的方法可能会降低MDRO传播风险。实施聚类干预措施在预防和控制MDRO方面被证明可提高效率和成本效益。早期筛查病原体种类是有助于控制抗菌药物使用的一项有价值策略。结合文献证据,实施包括对手卫生进行监测和反馈以及改进环境消毒技术等措施的聚类干预措施有助于预防和控制MDRO医院获得性感染。然而,需要进一步的临床研究来验证最佳的聚类干预措施。