阿拉伯联合酋长国重症监护病房入院时的耳念珠菌筛查。

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-01-08 DOI:10.1016/j.jiph.2025.102659

Sungsoo Park , Heesuk Kim , Kilchae Hwang , Duckjin Hong , Estephanie Padua , Eunjung Kim , Hyeyoung Oh

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引用次数: 0

摘要

背景：耳念珠菌筛查是遏制耳念珠菌传播的感染防控措施的重要组成部分之一。然而，先前的研究已经根据不同地区、医疗机构类型和不同流行程度的患者群体，对金黄色葡萄球菌筛查的有效性产生了不同的结果。我们的目的是评估在重症监护病房（ICU）入院时常规耳念珠菌筛查的临床效果。方法：回顾性研究纳入3356例ICU患者筛查前（N = 1658,2020年6月至2021年11月）和筛查后（N = 1698,2022年6月至2023年11月）。从腋窝和腹股沟采集耳球菌筛选拭子，进行培养，并使用基质辅助激光解吸/电离飞行时间（MALDI-TOF）质谱法或VITEK 2 YST识别卡进行鉴定。我们比较了筛查前后的金黄色葡萄球菌阳性率。结果：在1698例接受耳球菌筛查的患者中，只有4例（0.2 %）检测呈阳性。筛查方案实施前后的阳性率分别为2.92例/ 1000患者日（36/12333）和2.36例/ 1000患者日（21/8909），差异无统计学意义（P = 0.435）。中断时间序列分析显示筛选程序没有立即（P = 0.775）或持续（P = 0.484）的影响。对内科ICU患者的亚组分析也显示了类似的结果。结论：ICU入院时通用的C. auris筛查发现了少数病例。相反，可以采用有针对性的筛查和定期的点流行率调查，以及其他感染预防和控制措施。需要在不同的环境下采用不同的检测策略进行进一步的研究，以建立最有效的金黄色葡萄球菌筛查方法。

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Screening of Candida auris upon admission to an intensive care unit in the United Arab Emirates

Background

Candida auris screening is one of the crucial components of infection prevention and control measures to curb the spread of C. auris. However, previous research has yielded various results on the effectiveness of C. auris screening according to region, type of healthcare facility, and patient group in the various levels of endemicity. We aimed to assess the clinical effectiveness of routine C. auris screening upon admission to the intensive care unit (ICU).

Methods

This retrospective study involved 3356 ICU patients during pre-screening (N = 1658, June 2020 to November 2021) and post-screening period (N = 1698, June 2022 to November 2023). Swabs for C. auris screening were taken from axilla and groin, then cultured, and identified using either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 YST identification card. We compared the positivity rates of C. auris during the pre- and post-screening period.

Results

Of the 1698 patients who underwent C. auris screening, only 4 (0.2 %) tested positive. The positivity rates before and after the introduction of the screening program were 2.92 cases per 1000 patient days (36/12333) and 2.36 (21/8909), respectively, without significant difference (P = 0.435). Interrupted times series analysis showed no immediate (P = 0.775) or sustained (P = 0.484) effects from the screening program. Subgroup analysis of patients in the medical ICU showed similar results.

Conclusions

Universal C. auris screening upon ICU admission identified a small number of cases. Instead, targeted screening and regular point prevalence surveys, along with other infection prevention and control measures may be employed. Further studies in various settings with diverse testing strategies are needed to establish the most effective approach for C. auris screening.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.