前 COVID-19 时代的医疗感染和抗菌药消耗:意大利中部地区三家医院的点流行率调查。

Manuela Tamburro, Angelo Salzo, Michela Lucia Sammarco, Giancarlo Ripabelli
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引用次数: 0

摘要

导言:医疗相关感染(HAIs)是全球公共卫生关注的一个主要问题,它增加了耐药性感染的传播。这项点流行率调查研究了意大利中部一个地区的公立医院在前 COVID-19 时代的 HAIs 发生率和抗菌药物消耗量(AMC):方法:采用欧洲疾病预防与控制中心(European Centre for Disease Prevention and Control)的标准化方案收集数据:研究共纳入了 364 名患者(59.3% 为男性)。总体而言,HAIs 感染率为 6.6%(95%CI 4.4-9.5),调查医院内的感染率从 5.2% 到 7.1% 不等,24 名患者(内科和外科专科病房各 10 名,重症监护病房 4 名)中至少有一人感染。高龄、接受过手术和佩戴侵入性设备是导致 HAIs 的风险因素。在调查期间,44.7%(95%CI 39.7-49.9)的患者正在接受至少一种抗生素的治疗,各医院的 AMC 在 43% 和 48% 之间。在所有医院中,除预防或治疗外,其他处方的使用率均高于 10%:结果显示,与最新的全国数据相比,HAIs 的流行率低于估计值,而抗菌药物的使用率却较高。这些研究结果突出表明,有必要加强卫生习惯并制定针对 HAIs 的捆绑措施,因为在枢纽医院和辐条医院广泛实施感染预防和控制措施,可以显著减少 HAIs 的发生,并实施抗菌药物管理以确保处方的适当性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Healthcare infections and antimicrobial consumption in pre-COVID-19 era: a point prevalence survey in three hospitals in a region of Central Italy.

Introduction: Healthcare-associated infections (HAIs) are a major global public health concern, increasing the transmission of drug-resistant infections. This point prevalence survey investigated HAIs occurrence and antimicrobial consumption (AMC) in pre-COVID-19 era in the public hospitals of a region of Central Italy.

Methods: Data were collected using the protocol standardised by the European Centre for Disease Prevention and Control.

Results: Three-hundred and sixty-four patients were included (59.3% male) in the study. Overall, HAIs prevalence was 6.6% (95%CI 4.4-9.5), ranging from 5.2% to 7.1% within the surveyed hospitals, with at least one infection in 24 patients (ten each in medical and surgical specialties wards, and four in intensive care). Risk factors for HAIs were advanced age, having undergone surgery and wearing invasive devices. At time of the survey, 44.7% (95%CI 39.7-49.9) of patients was under treatment with at least one antibiotic, and AMC varied between 43% and 48% within hospitals. In all hospitals, a prevalence higher than 10% was found for the prescription reasons other than prophylaxis or therapy.

Conclusions: The results revealed a HAIs prevalence lower than that estimated compared to the most recent national data, in contrast to higher antimicrobial usage. These findings highlight the need to reinforce hygiene practices and develop bundles for HAIs, as a broad implementation of infection prevention and control practices extensively applied to both hub and spoke hospitals could significantly reduce their occurrence, as well as to implement antimicrobial stewardship for prescriptive appropriateness.

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