确保患者安全:处理与硬膜外麻醉有关的脑膜炎疫情;墨西哥的教训

Nicholas Aderinto, G. Olatunji
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引用次数: 0

摘要

硬膜外麻醉相关的脑膜炎暴发是罕见的,但在医疗环境中值得关注。这些暴发可由多种因素引起,如药物污染、无菌技术的破坏、免疫损害、插管时间延长和消毒措施不充分。在研究人员进行的一项系统综述中,研究了234例报告的脓毒性脑膜炎病例,包括22项流行病学研究和71篇病例报告文章。在这些病例中,10例涉及混合神经轴麻醉,25例涉及硬膜外麻醉,199例涉及脊髓麻醉。特别是,研究人员确定了一个普遍的风险因素:手术期间没有使用外科口罩,占41例(16.7%)。本文通信的重点是最近在墨西哥马塔莫罗斯爆发的真菌性脑膜炎。通过检查这个病例,我们的目的是强调严格的方案,适当的无菌技术,设备消毒和患者监测的重要性,以尽量减少感染风险,确保患者的健康。分析将包括疫情的起源、后果和挑战,为预防和缓解疫情提供专家见解和基于证据的建议。此外,它还将强调早期发现、监测和充分准备措施的重要性。最后,本文深入探讨了确保患者安全的重要性,探讨了导致脑膜炎暴发的因素,并强调了可从墨西哥情况中获得的宝贵经验教训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ensuring patient safety: addressing meningitis outbreaks linked to epidural anesthesia; lessons from Mexico
Epidural anesthesia-related meningitis outbreaks are a rare but significant concern within medical settings. These outbreaks can occur due to various factors, such as contaminated medication, breaches in aseptic technique, immune compromise, prolonged catheterization, and inadequate disinfection practices. In a systematic review conducted by researchers, 234 reported cases of septic meningitis were examined, comprising 22 epidemiological studies and 71 case-report articles. Among these cases, 10 involved mixed neuraxial anesthesia, 25 were associated with epidural anesthesia, and 199 were linked to spinal anesthesia. In particular, the researchers identified a prevalent risk factor: the absence of surgical mask use during surgeries, accounting for 41 cases (16.7%). This correspondence focuses on a recent fungal meningitis outbreak in Matamoros, Mexico. By examining this case, we aim to emphasize the importance of stringent protocols, proper aseptic techniques, equipment sterilization, and patient monitoring to minimize infection risks and ensure patient well-being. The analysis will encompass the outbreak’s origin, consequences, and challenges, providing expert insights and evidence-based recommendations for prevention and mitigation. In addition, it will underscore the importance of early detection, surveillance, and adequate preparation measures. Ultimately, this correspondence delves into the importance of ensuring patient safety, explores the factors contributing to meningitis outbreaks, and highlights valuable lessons that can be derived from the Mexican context.
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