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重症监护病房中的含银滤网。一种控制多重耐药菌交叉传播的新工具。

Silver-embedded screens in the intensive care unit. A new tool to control multi-drug resistant bacterial cross-transmission.

机构信息

Hospital Universitario y Politécnico la Fe, Valencia, Spain.

出版信息

Eur J Clin Microbiol Infect Dis. 2017 Aug;36(8):1505-1509. doi: 10.1007/s10096-017-2959-y. Epub 2017 Mar 20.

Abstract

The purpose of this study was to assess the effectiveness of silver-embedded surfaces (BactiBlock®) to prevent surface colonization by multi-resistant bacteria (MRB) and to reduce the incidence of MRB colonization and infection in patients admitted to an intensive care unit (ICU). A 6-month prospective observational study in a 24-bed mixed ICU divided into two identical subunits (12 beds each) was designed. Seven solid mobile screens were placed in one of the subunits while in the other cloth screens remained. Solid screens were constructed with high-density polyethylene embedded in Bactiblock®. To evaluate the effectiveness of screens coated with Bactiblock®, number of MRB isolates on screens were compared for 6 months. Likewise, numbers of new patients and ICU-stays with MRB colonization in the two subunits were compared. One hundred forty screen samples were collected in 10-point prevalent days. MRB were detected on 28 (20.0%) samples. Over the 70 samples taken on cloth folding screens, MRB were detected in 25 (35.7%), while only 3 (4.3%) of the 70 samples taken on Bactiblock® screens were positive for MRB (p < 0.001). The unit with Bactiblock® screens presented fewer number of ICU stays with MRB colonization (27.8% vs 47.1%; p < 0.001). No significant differences were found in the global incidence of MRB nosocomial infection. The presence of Bactiblock® embedded in solid folding screens avoided MRB surface colonization and reduced MRB transmission to patients admitted to critical care units, proving to be an useful tool in the control of MRB.

摘要

本研究旨在评估含银表面(BactiBlock®)对预防多耐药菌(MRB)表面定植的有效性,并降低重症监护病房(ICU)患者的 MRB 定植和感染发生率。设计了一项为期 6 个月的前瞻性观察研究,在 24 张床位的混合 ICU 中分为两个相同的亚组(各 12 张床位)。在其中一个亚组中放置了 7 个固定的移动屏风,而另一个亚组则保留了布制屏风。固定屏风由嵌入 Bactiblock®的高密度聚乙烯制成。为了评估涂有 Bactiblock®的屏风的有效性,比较了 6 个月内屏风上 MRB 分离株的数量。同样,比较了两个亚组中出现新患者和 MRB 定植的 ICU 入住情况。在 10 个流行日采集了 140 个屏风样本。在 28 个(20.0%)样本中检测到了 MRB。在对布制折叠屏风采集的 70 个样本中,有 25 个(35.7%)检测到了 MRB,而在对 Bactiblock®屏风采集的 70 个样本中,只有 3 个(4.3%)样本检测到了 MRB(p<0.001)。使用 Bactiblock®屏风的单元中,MRB 定植的 ICU 入住次数较少(27.8%比 47.1%;p<0.001)。MRB 医院感染的总体发生率没有显著差异。在固体折叠屏风上添加 BactiBlock®可以避免 MRB 表面定植,并减少 MRB 向入住重症监护病房的患者传播,这证明是控制 MRB 的有效工具。

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