【推荐综述】多重预防和感控措施能够降低医院内MDRO的感染
本帖最后由 蓝鱼o_0 于 2011-6-21 09:12 编辑Multiple prevention and control programs may reduce MDRO infections in hospitals
Backman C. Am J Infect Control. 2011;39:368-378.
这篇review综述了急性病医疗机构中，感染控制措施与MDRO感染的关系，结论通过多重预防和控制程序能够降低ACH MDRO的感染。
综述了32篇研究，并且对不同的感染控制措施，进行了定量描述。对了解MDRO的感控措施，以及了解目前这个领域里面的研究概况有很重要的指导意义。
推荐大家去阅读。
Submit a Comment Email Print Implementation of multiple prevention interventions could potentially reduce multidrug-resistant organism infections in acute care hospitals, according to new findings published in the American Journal of Infection Control.
“Although major methodologic weaknesses exist in the published literature making it not possible to exclude other plausible explanations for the reduction of the acquisition of MDRO, the overall evidence does support the use of multiple interventions to reduce the rates of MDRO in acute care hospitals,” the researchers wrote.
Chantal Backman, PhD
Chantal Backman, PhD, of the faculty of nursing at the University of Alberta in Canada, and colleagues pooled data from 32 studies published between Jan. 1, 1998, and May 14, 2009, to examine the effectiveness of MDRO infection control programs in the acute care hospital setting.
Overall, the following types of interventions were used:
——一下这些数据，大家在做PPT的时候可能会用到。
75% of studies used infection control precautions to prevent transmission.
62.5% of studies used education and training of health care personnel.
56.25% of studies used an administrative measure.
53.1% of studies used surveillance.
28.1% studies used patient decolonization.
25% of studies included judicious use of antimicrobial agents.
21.9% of studies used environmental measures.
All interventions were associated with decreases in MDRO infections, according to the researchers. However, they cited limitations with nondescriptive study designs and methods.
"Further outbreak and intervention studies should be written in a standardized manner — following the ORION guideline recommendations," Backman told Infectious Disease News. "Studies to better understand the relationships between each of the components of an infection prevention and control program are needed." – by Ashley DeNyse
Disclosure:The researchers report no relevant financial disclosures.
【全文见附件】
可恨哪，我是个英语方盲，看不懂{:1_4:} 75% of studies used infection control precautions to prevent transmission.
62.5% of studies used education and training of health care personnel.
56.25% of studies used an administrative measure.
53.1% of studies used surveillance.
28.1% studies used patient decolonization.
25% of studies included judicious use of antimicrobial agents.
21.9% of studies used environmental measures.
荟萃得来的数据，很有用！ 真是及时雨啊，正需要这方面的数据，灰常感谢蓝鱼！！ patient decolonization.这个怎么翻译啊？求解答 回复 5# swinburn
病患脱定植，比如MRSA的病患进行临床用药（莫匹罗星，万古霉素，利奈唑胺等等），使得跟踪后的MRSA变成阴性。 想问蓝鱼版主一下，对于多耐药菌的早期筛查，如MRSA VRE筛查后的具体处理措施有哪些，这个方面有什么最新的进展吗？ 回复 7# swinburn
您的问题太大啦，有治疗有预防，还有一些前瞻性的研究成果。这个问题的答案会是一片不错的综述。
如果您想了解治疗和感控方面的知识，论坛里面有很多介绍。
包括这次SIFIC2011大会，胡教授有专门的ASC讲座。由课题设计，到采样，到专门的培养基筛查等等。我写过一片感想，您可以去参考一下。
关于主动筛查的帖子，论坛里面有很多。我检索了一下：
http://bbs.sific.com.cn/search.php?searchid=695&orderby=lastpost&ascdesc=desc&searchsubmit=yes
您可以去看看。 回复 7# swinburn
主动筛查后有去定植和去污染两个方面，处理措施也包括对病患，医护人员和对环境。以MRSA为例，可以用万古霉素，莫匹罗星和利奈唑胺等等。临床实验的结果还是可以的。但是后者比较昂贵。
去污染方法就比较多，有消毒和药物处理。
此外还牵涉到手卫生。这是最基础的。这次WHO的感控专家。DR DIDIER PIPETER有详细的介绍。
如果你想细细了解，可以选择一个小的方面，寻找一个合适的切入点，再具体讨论。 很好的文章，谢谢！
decolonization这个词，有的人翻译为去定植，有的人翻译为去污染，有什么区别吗？求教高人 应该是去定植，定植的英文是colonization，去定植即除去定植在体表的病原体。如果去污染的话，应使用decontamination. 回复 10# yhuister
是有区别的，decolonization去定植，方法来自于临床抗生素比如莫匹罗星涂抹以清除MRSA，洗必泰洗浴清除MDRO等等。
decontamination，去污染，方法有的是通过消毒的方法，比如对环境进行清洁和消毒的。 很好的文章，谢谢楼主，认真学习，同时学习外语！ 谢谢提供多重感染最新资料！好好学习为院内感染控制做贡献！ 谢谢楼主提供的文献，难得下到全文呢 很好的文章{:1_1:}{:1_1:}{:1_1:}
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