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Containing Carbapenemase-producing Klebsiella pneumoniae in an endemic setting.
Antimicrobial Resistance & Infection Control ( IF 4.8 ) Pub Date : 2020-07-06 , DOI: 10.1186/s13756-020-00766-x
Kalliopi Spyridopoulou 1 , Mina Psichogiou 1 , Vana Sypsa 2 , Vivi Miriagou 3 , Amalia Karapanou 1 , Linos Hadjihannas 1 , Leonidas Tzouvelekis 4 , George L Daikos 1
Affiliation  

Carbapenemase-producing K. pneumoniae (CP-Kp) has been established as important nosocomial pathogen in most tertiary care hospitals in Greece. The aim of the present study was to examine the impact of an enhanced infection control program on the containment of CP-Kp in a haematology unit where the incidence of CP-Kp infections was high. The study was conducted from June 2011 to December 2014 in a haematology unit of a tertiary-care 500-bed hospital located in Athens, Greece. A bundled intervention (active surveillance cultures, separation of carriers from non-carriers, assignment of dedicated nursing staff, contact precautions, environmental cleaning, and promotion of hand hygiene) was tested whether would reduce colonization and infection caused by CP-Kp. A total of 2507 rectal swabs were obtained; 1199 upon admission from June 2011 to June 2013 and 1307 during hospitalization from June 2011 to December 2012. During intervention the admission prevalence of CP-Kp colonization (p < 0.001 for linear trend), the hospitalization prevalence (p = 0.001 for linear trend) and the incidence rate of CP-Kp colonization (p = 0.072 for linear trend) were declining. Application of segmented linear regression revealed that both the change in the level of CP-Kp BSI incidence rates (p = 0.001) as well as the difference between pre- and post-intervention slopes were statistically significant (p < 0.001). A bundled intervention including active surveillance cultures on admission can attain maximum containment of CP-Kp colonization and infection in endemic acute healthcare settings.

中文翻译:

在地方性环境中含有产碳青霉烯酶的肺炎克雷伯菌。

产生碳青霉烯酶的肺炎克雷伯菌(CP-Kp)在希腊的大多数三级护理医院中已被确定为重要的医院病原体。本研究的目的是研究在CP-Kp感染发生率较高的血液科中,加强感染控制程序对CP-Kp遏制的影响。该研究于2011年6月至2014年12月在希腊雅典一家拥有500张床位的三级护理医院的血液病学部门进行。测试了捆绑的干预措施(主动监视文化,将携带者与非携带者分开,指派专职护理人员,接触预防措施,环境清洁和促进手部卫生)是否会减少由CP-Kp引起的定植和感染。总共获得了2507个直肠拭子。从2011年6月至2013年6月入院时为1199,从2011年6月至2012年12月在住院期间为1307。在干预期间,CP-Kp菌落的入院率(线性趋势为p <0.001),住院率(线性趋势为p = 0.001)并且CP-Kp定植的发生率(线性趋势为p = 0.072)正在下降。分段线性回归的应用表明,CP-Kp BSI发生率水平的变化(p = 0.001)以及干预前后的斜率之间的差异均具有统计学意义(p <0.001)。在流行的急性医疗机构中,包括入院时进行主动监视培养在内的捆绑干预措施可以最大程度地抑制CP-Kp的定植和感染。在干预期间,CP-Kp菌落的入院率(线性趋势为p <0.001),住院率(线性趋势为p = 0.001)和CP-Kp菌落的发生率(线性趋势为p = 0.072)正在下降。分段线性回归的应用表明,CP-Kp BSI发生率水平的变化(p = 0.001)以及干预前后的斜率之间的差异均具有统计学意义(p <0.001)。在流行的急性医疗机构中,包括入院时进行主动监视文化在内的捆绑干预措施可以最大程度地抑制CP-Kp的定植和感染。在干预期间,CP-Kp菌落的入院率(线性趋势为p <0.001),住院率(线性趋势为p = 0.001)和CP-Kp菌落的发生率(线性趋势为p = 0.072)正在下降。分段线性回归的应用表明,CP-Kp BSI发生率水平的变化(p = 0.001)以及干预前后的斜率之间的差异均具有统计学意义(p <0.001)。在流行的急性医疗机构中,包括入院时进行主动监视培养在内的捆绑干预措施可以最大程度地抑制CP-Kp的定植和感染。线性趋势为001)和CP-Kp定植的发生率(线性趋势为p = 0.072)正在下降。分段线性回归的应用表明,CP-Kp BSI发生率水平的变化(p = 0.001)以及干预前后的斜率之间的差异均具有统计学意义(p <0.001)。在流行的急性医疗机构中,包括入院时进行主动监视培养在内的捆绑干预措施可以最大程度地抑制CP-Kp的定植和感染。线性趋势为001)和CP-Kp定植的发生率(线性趋势为p = 0.072)正在下降。分段线性回归的应用表明,CP-Kp BSI发生率水平的变化(p = 0.001)以及干预前后的斜率之间的差异均具有统计学意义(p <0.001)。在流行的急性医疗机构中,包括入院时进行主动监视培养在内的捆绑干预措施可以最大程度地抑制CP-Kp的定植和感染。
更新日期:2020-07-06
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