Efficacy of environmental measures to decrease the risk of hospital-acquired aspergillosis in patients hospitalised in haematology wards
Efficacy of environmental measures to decrease the risk of hospital-acquired aspergillosis in patients hospitalised in haematology wards
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DOI：
10.1111/j.1469-0691.2006.01499.x
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发表时间：
2006-08-01
影响因子：
14.2
通讯作者：
Guyotat, D.
中科院分区：
文献类型：
--
作者：
Berthelot, P.;Loulergue, P.;Guyotat, D.
本研究评估了一种多学科策略，以降低圣艾蒂安大学医院一栋560张床位的大楼内两个血液科病房住院的成人患者的侵袭性肺曲霉菌病（IPA）发生率。1994年完成了空气过滤系统的改进和在该单位入口处建造一个气闸室的工作。1995年，在医院建筑工程中采取了具体的卫生措施，包括使用塑料屏障，在拆除工作中浇水，减少建筑区的行人交通，以及免疫抑制病人在保护单位外佩戴高效过滤口罩。通过对1993年至2001年期间的IPA病例进行前瞻性调查以及环境监测，对这一战略进行了评估。1995年至2001年期间，医院翻修项目的数量和风险水平均有所增加（p < 0.01）。同时，血液科的IPA发生率从1993年的0.85%（1.19/1000例患者）降至2001年的0.28%（0.21/1000例患者）。1993-1996年和1997-2001年期间，IPA的发生率显著降低（p 0.02，Mann-Whitney检验）。这些结果表明，涉及工程师，感染控制从业人员，真菌学家和临床医生的多学科方法使血液科病房住院患者的IPA率显着降低。
This study evaluated a multidisciplinary strategy to decrease the rate of invasive pulmonary aspergillosis (IPA) among adult patients hospitalised in two haematology wards in a single 560-bed building at the University Hospital of Saint-Etienne. Upgrading of the air filtration system and construction of an air-lock chamber at the entrance to the unit were completed during 1994. In 1995, specific hygienic measures were introduced during hospital building work, including the use of plastic barriers, watering during demolition work, reduction of pedestrian traffic in construction areas, and the wearing of high-efficiency filtration masks by immunosuppressed patients when outside the protected unit. This strategy was evaluated by a prospective survey of IPA cases between 1993 and 2001, coupled with environmental surveillance. The number and risk-level of hospital renovation projects increased between 1995 and 2001 (p < 0.01). In parallel, the rate of IPA decreased globally in the haematology unit from 0.85% (1.19/1000 patients) in 1993 to 0.28% (0.21/1000 patients) in 2001. The incidence of IPA decreased significantly between 1993-1996 and 1997-2001 (p 0.02, Mann-Whitney test). These results show that a multidisciplinary approach involving engineers, infection control practitioners, mycologists and clinicians enables IPA rates among patients hospitalised in haematology wards to be significantly decreased.