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预防和控制医疗保健相关感染:医院环境中每个抗菌药物管理计划的首要原则。

Preventing and Controlling Healthcare-Associated Infections: The First Principle of Every Antimicrobial Stewardship Program in Hospital Settings.

作者信息

Sartelli Massimo, Marini Corrado P, McNelis John, Coccolini Federico, Rizzo Caterina, Labricciosa Francesco M, Petrone Patrizio

机构信息

Department of Surgery, Macerata Hospital, 62100 Macerata, Italy.

Jacobi Medical Center, New York Medical College, Bronx, NY 10461, USA.

出版信息

Antibiotics (Basel). 2024 Sep 20;13(9):896. doi: 10.3390/antibiotics13090896.

Abstract

Antimicrobial resistance (AMR) is one of the main public health global burdens of the 21st century, responsible for over a million deaths every year. Hospital programs aimed at improving antibiotic use, referred to as antimicrobial stewardship programs (ASPs), can both optimize the treatment of infections and minimize adverse antibiotics events including the development and spread of AMR. The challenge of AMR is closely linked to the development and spread of healthcare-associated infection (HAIs). In fact, the management of patients with HAIs frequently requires the administration of broader-spectrum antibiotic regimens due to the higher risk of acquiring multidrug-resistant organisms, which, in turn, promotes resistance. For this reason, even before using antibiotics correctly, it is necessary to prevent and control the spread of HAIs in our hospitals. In this narrative review, we present seven measures that healthcare workers, even if not directly involved in the tasks of infection prevention and control, must know, support, and embrace. We hope that this review may raise awareness among all healthcare professionals about the issues with the increasing rate of AMR and the ongoing efforts towards minimizing its rise.

摘要

抗菌药物耐药性(AMR)是21世纪全球主要的公共卫生负担之一,每年导致超过100万人死亡。旨在改善抗生素使用的医院项目,即抗菌药物管理项目(ASP),既能优化感染治疗,又能将包括AMR的发生和传播在内的不良抗生素事件降至最低。AMR的挑战与医疗保健相关感染(HAI)的发生和传播密切相关。事实上,由于感染多重耐药菌的风险较高,HAI患者的管理通常需要使用更广泛的抗生素治疗方案,这反过来又会促进耐药性。因此,即使在正确使用抗生素之前,也有必要在我们的医院预防和控制HAI的传播。在这篇叙述性综述中,我们提出了七项措施,即使没有直接参与感染预防和控制任务的医护人员也必须了解、支持并接受。我们希望这篇综述能够提高所有医疗专业人员对AMR发生率上升问题以及为尽量减少其上升所做持续努力的认识。

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