Decolonization, containment or source control? Pathogen-specific anti-infective prevention for methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Enterobacterales (CRE) and Candida auris.

IF 4.6 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2026-08-13 DOI:10.1080/14787210.2026.2718192

Abdelaziz Touati

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引用次数: 0

Abstract

Introduction: Healthcare systems use decolonization, screening, patient placement, environmental cleaning and stewardship to prevent Methicillin-Resistant Staphylococcus aureus (MRSA), Carbapenem-Resistant Enterobacterales (CRE) and Candida auris transmission and infection. These interventions share an Infection Prevention and Control (IPC) foundation but differ in evidence, operational demands and the reservoirs they target.

Areas covered: This critical narrative review compares pathogen-targeted and universal (horizontal) strategies, including topical decolonization, antiseptic bathing, surveillance-linked containment, environmental/source control and antimicrobial stewardship. It examines study design, endpoint directness, diagnostic intensity, implementation fidelity, feasibility and local resource constraints.

Expert opinion: The three pathogen pathways are analytical emphases rather than mutually exclusive models. MRSA has the most developed trial evidence for topical decolonization in selected settings, although chlorhexidine effects may also be horizontal. CRE and C. auris prevention generally requires universal IPC measures combined with targeted screening, placement, environmental control or emerging adjunctive decolonization according to local epidemiology and capacity.

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非殖民化、遏制还是源控制？耐甲氧西林金黄色葡萄球菌（MRSA）、耐碳青霉烯肠杆菌（CRE）和金黄色念珠菌的特异性抗感染预防。

卫生保健系统使用去菌落、筛查、患者安置、环境清洁和管理来预防耐甲氧西林金黄色葡萄球菌（MRSA）、耐碳青霉烯肠杆菌（CRE）和金黄色念珠菌的传播和感染。这些干预措施具有感染预防和控制（IPC）基础，但在证据、操作需求和目标储层方面有所不同。涉及领域：这篇重要的叙述性综述比较了针对病原体的战略和普遍（横向）战略，包括局部非殖民化、消毒沐浴、与监测相关的遏制、环境/来源控制和抗菌剂管理。它检查了研究设计、终点直接性、诊断强度、实施保真度、可行性和当地资源约束。专家意见：这三种病原体途径是分析的重点，而不是相互排斥的模型。虽然氯己定的作用也可能是水平的，但在选定的环境中，MRSA局部去菌落的试验证据最为发达。CRE和auris的预防通常需要普遍的IPC措施，结合根据当地流行病学和能力进行有针对性的筛查、安置、环境控制或新出现的辅助去殖民化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.