【挑战】对SHEA/HICPAC关于MDRO度量的挑战！！

蓝鱼o_0

尽信书不如无书。科学需要不同的声音。
就全球而言，SHEA/HICPAC对于MDRO的度量（界定）预防控制已经成为标杆，相继为各个国家采用，效仿。有一个研究团队，运用SHEA/HICPAC对推荐的度量在真实世界进行了验证，他们提出了自己的看法和质疑。
全文已经UPLOAD！

——由于摘要是速译。可能存在一定的小错误，欢迎大家批评指正！
【PAPER】
Infect Control Hosp Epidemiol. 2011 Apr;32(4):323-32.

Challenges of Applying the SHEA/HICPAC Metrics for Multidrug-Resistant Organisms to a Real-World SettingAbstractOBJECTIVE:
To test in a real-world setting the recommendations for measuring infection with multidrug-resistant organisms (MDRO) from the Society for Healthcare Epidemiology of America (SHEA) and the Centers for Disease Control and Prevention's Healthcare Infection Control Practices Advisory Committee (HICPAC).METHODS:
Using data from 3 hospital settings within a healthcare network, we applied the SHEA/HICPAC recommendations to measure methicillin-resistant Staphylococcus aureus (MRSA) infection and colonization. Data were obtained from the hospitals' electronic surveillance system and were supplemented by manual medical record review as necessary. Additionally, we tested (1) different definitions for nosocomial incidence, (2) the effect of excluding patients not at risk from the denominator for hospital-onset incidence, and (3) the appropriate time period to use when including or excluding patients with a prior history of MRSA infection or colonization from nosocomial rates. Negative binomial regression models were used to test for differences between rate definitions. A rating scale was created for each metric, assessing the extent to which manual or electronic data elements were required.RESULTS:
There was no statistically significant difference between using 72 hours or 3 calendar days as the cutoff to define hospital-onset incidence. Excluding patients not at risk from the denominator when calculating hospital-onset incidence led to statistically significant increases in rates. When excluding patients with a prior history of MRSA infection or colonization from nosocomial incidence rates, rates were similar regardless of whether we looked at 1, 2, or 3 years' worth of prior data.CONCLUSIONS:
The SHEA/HICPAC MDRO metrics are useful but can be challenging to implement. We include in our description of the data sources and processes required to calculate these metrics information that may simplify the process for institutions.

摘要
目的：测试在真实环境中，SHEA和HICPAC对MDRO的检测推荐。

方法：使用医疗网络内的3家医院，我们采用了SHEA/ HICPAC建议措施检验甲氧西林耐药金黄色葡萄球菌（MRSA）的感染与定植。数据来自医院的电子监视系统，并在必要时人工病历审查补充。此外，我们测试（1）院内的发病率不同的定义，（2）将非医院获得性感染的病例从分母中排除，以及（3）MRSA感染史获得性定植或者感染者的最佳定位时间。建立“负二项回归”模型，用来测试速度的定义之间的差异。建立一种尺度，以评价手动或电子数据被要求的程度。

结果：以72小时或者3天定义医院感染获得的截止时间，两者的医院获得性发生率无显著性差别。分母中扣除曾经发生过医院感染的发生者后，医院获得性感染发生率显著增加。当排除曾经发生过既往感染后，两者之间较为接近（查询了一年，两年，3年内有价值的疾病史)


结论：SHA/ HICPAC 对MDRO指标是有用的，但在实际实施中可以变通。我们通过对数据源的描述和计算这些指标信息的过程，而这些是可以简化的。

toto

目的：测试在真实环境中，SHEA和HICPAC对MDRO的检测推荐????我没很搞懂这个研究做的意义到底是什么

HOPE-H

嘿嘿，英文版的，好好研读！