马上注册登录，享用更多感控资源，助你轻松入门。
您需要 登录 才可以下载或查看，没有账号？注册
|
×
耐碳青霉烯类肠杆菌（CRE）的全球传播！2016-06-13 SIFIC热点团队 SIFIC官微
耐碳青霉烯类肠杆菌（CRE）的全球传播 ——对患者和医疗系统构成威胁 Global Spread of CRE is a Threat to Patients and Healthcare Systems
检索：刘金淑 译者：刘金淑 编写：陈志锦 审核：唐文瑞、陈志锦 耐碳青霉烯类肠杆菌(CRE)感染与高死亡率相关，主要是由于延误有效治疗和有效治疗选择有限。用于治疗多重耐药细菌感染患者的最后防线是碳青霉烯类抗生素，能够取而代之的新抗生素，在短期内不可能面世。此外，耐碳青霉烯类肠杆菌适宜在医疗机构和社区中传播。
欧洲疾病预防和控制中心(ECDC)的风险评估概述了CRE当前和未来可能对人类健康的风险、在医疗机构和社区中的潜在传播风险，以及欧盟/欧洲经济区成员国之间和第三国必须考虑的跨境方面的风险。这份风险评估中也列举了具体可行的管理措施。
在医院和其他医疗机构中，防止CRE传播的措施包括：
来源：欧洲疾病预防和控制中心(ECDC)解读：由于CRE感染患者有很高的死亡率，同时对多种抗菌药物耐药并已经在美国很多地区出现且具有更广泛的传播趋势，因此具有流行病学重要性。鉴于CRE在美国的出现和播散，美国疾病预防控制中心（Centers for Disease Control and Prevention，CDC）于2012年颁布了耐碳青霉烯类肠杆菌控制指南。
可采取8项措施以防止CRE院内传播： 1、确保医务人员严格遵循手卫生程序并监测手卫生坚持率以及时反馈，医疗机构应建立充足的手卫生设施并保持其整洁； 2、对于CRE感染患者采取接触隔离措施，包括穿隔离衣戴手套之前洗手，进入感染患者房间之前穿隔离衣戴手套且离开时脱掉隔离衣及手套并洗手； 3、对于从CRE感染高发地区转入的患者，在其筛查培养物结果未明确之前，应采取预防性接触隔离措施； 4、对医护人员进行CRE防护的教育，至少应包括合理采取接触隔离措施和手卫生程序； 5、尽量减少患者的有创操作，包括中心静脉插管等； 6、定植或感染CRE的患者应住单人病房或集中并请专人护理；临床微生物实验室及时将CRE结果通知临床和感染管理部门； 7、合理应用抗菌药物治疗CRE感染患者； 8、采集粪便、直肠或肛周拭子进行CRE筛查，让接受转诊CRE定植患者的医院提高警惕性。 英文原文Carbapenem-resistant Enterobacteriaceae (CRE) infections are associated with high mortality, primarily due to delays in administration of effective treatment and the limited availability of effective treatment options. New antibiotics capable of replacing carbapenems, a last-line group of antibiotics used to treat patients infected with multidrug-resistant bacteria, are not likely to become available in the near future. Furthermore, CRE are adapted to spread in healthcare settings as well as in the community.
A European Centre for Disease Prevention and Control (ECDC) risk assessment outlines the current and possible future risks for human health, the potential for spread both in healthcare settings and in the community, and cross-border aspects that must be taken into consideration both in EU/EEA Member States and in third countries. Options for action addressing these areas are presented also presented in this document.
Options to prevent transmission of CRE in hospitals and other healthcare settings include: timely and appropriate laboratory investigation to avoid delay in appropriate treatment, good standard infection control practices, screening of patients considered at high risk of digestive tract carriage of CRE, enhanced control measures in healthcare settings (contact precautions, patient isolation or cohorting, and dedicated nursing) for patients who are CRE-positive, and the development of antimicrobial stewardship programs.
Source: European Centre for Disease Prevention and Control (ECDC) 图文编辑：小小牧童
| 
/1 
发表于 2016-6-13 22:45
发表于 2016-6-16 00:02
防、防、防！感谢老师分享！