一篇关于在ICU如何降低与交叉感染和耐药菌扩散相关的死亡率的综述

David

Clinical Microbiology and Infection
Volume 14 Issue 1 Page 5-13, January 2008

REVIEW
Limiting the attributable mortality of nosocomial infection and multidrug resistance in intensive care units
一篇关于在ICU如何降低与交叉感染和耐药菌扩散相关的死亡率的综述
S. BlotIntensive Care Department, Ghent University Hospital and Health Care Department, University College Ghent, Ghent, Belgium
Corresponding author and reprint requests: S. Blot, Ghent University Hospital, Intensive Care Department, De Pintelaan 185, 9000 Ghent, Belgium
E-mail: stijn.blot@ugent.be
Abstract

Severe nosocomial infections and multidrug resistance (MDR) are associated with a poor prognosis for patients in intensive care units. This is partly because most of these patients suffer from high disease severity and acute illness before the onset of infection. Nevertheless, the mortality attributed directly to infection can also be devastating. However, the attributable mortality can be limited by taking account of a number of key points. General infection prevention measures, prevention of cross-transmission and a policy of restricted antimicrobial use are all important because of their positive influence on the rates of infection and MDR. In turn, this will increase the odds for successful empirical coverage of the causative microorganism. Once infection occurs, benefits are to be expected from early recognition of the septic episode and prompt initiation of empirical antimicrobial therapy. The choice of empirical therapy should be based on the local bacterial ecology and patterns of resistance, the presence of risk-factors for MDR, and the colonisation status of the patient. Attention should also be given to adequate doses of antimicrobial agents and, if possible, elimination of the sources of infection, e.g., contaminated devices or intra-abdominal collections or leakages. In the latter case, timely surgical intervention is essential. In addition, haemodynamic stabilisation and optimisation of tissue oxygenation can save lives.

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桂花香

Severe nosocomial infections and multidrug resistance (MDR) are associated with a poor prognosis for patients in intensive care units.严重的院内感染和多重耐药与ICU病人的预后差相关。 This is partly because most of these patients suffer from high disease severity and acute illness before the onset of infection. 这部分是因为病人在感染发生前患有严重的急性疾病。Nevertheless, the mortality attributed directly to infection can also be devastating.不论如何，感染导致的病死率也可以是严重的。 However, the attributable mortality can be limited by taking account of a number of key points. 然而，可以通过采取一些关键的措施来降低病死率。General infection prevention measures, prevention of cross-transmission and a policy of restricted antimicrobial use are all important because of their positive influence on the rates of infection and MDR.一般的感染控制措施，预防交叉感染和限制抗菌药物的使用很重要，因为这些措施对于感染率和多重耐药的控制有积极的影响。In turn, this will increase the odds for successful empirical coverage of the causative microorganism.反过来，这将提高覆盖致病菌的经验性治疗成功的可能性。Once infection occurs, benefits are to be expected from early recognition of the septic episode and prompt initiation of empirical antimicrobial therapy.一旦感染发生，可以期待早期识别脓毒症并及时给予经验性抗菌药物的好处。 The choice of empirical therapy should be based on the local bacterial ecology and patterns of resistance, the presence of risk-factors for MDR, and the colonisation status of the patient.经验性治疗应基于当地的细菌谱和耐药谱，MDR危险因素的存在与否以及病人的细菌定植状况。 Attention should also be given to adequate doses of antimicrobial agents and, if possible, elimination of the sources of infection, e.g., contaminated devices or intra-abdominal collections or leakages. 应给予足够的抗菌药物剂量，并且，如果可能，应清除感染源，例如污染的诊疗用物或腹腔内积液或渗漏。In the latter case, timely surgical intervention is essential. In addition, haemodynamic stabilisation and optimisation of tissue oxygenation can save lives.稍后，及时的外科处理是必要的。另外，血液动力学的稳定和组织的最佳供氧可以拯救生命。

绿茵场

谢谢啦，其实有很多这样的资料可以让临床的医生看看！:)

桂花香

谢谢加分！
把感染控制的信息和新的理念介绍给临床医师是我们义不容辞的责任！而要让他们接受并自觉使用新的感染控制理念需要我们不懈的努力！

温暖

非常感谢，下载学习了，有这样中英文对照的文献，学习起来非常方便。多谢！

温暖

非常感谢，下载学习了，有这样中英文对照的文献，学习起来非常方便。多谢！

carefirst

Limiting the attributable mortality of nosocomial infection and multidrug resistance in intensive care units
一篇关于在ICU如何降低与交叉感染和耐药菌扩散相关的死亡率的综述

老师，为什么您把这个题目翻译成“交叉感染”呢？