Lessons from a community-based infection prevention study.
Lessons from a community-based infection prevention study.
复制标题
基于社区的感染预防研究的经验教训。
DOI：
10.1086/657137
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
Popovich,KyleJ
中科院分区：
文献类型：
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作者：
Popovich,KyleJ
葡萄糖酸氯己定（CHG）是一种抗菌剂，已用于多种目的，包括导管插入准备和维护、1身体抗菌、2以及鼻咽和口咽应用。3用这种药剂进行消毒被认为可以减少潜在病原体的定植，”这反过来又会在理论上导致感染数量的减少。使用CHG布为重症监护病房患者洗澡可有效降低中心静脉导管相关血流感染率2，5和万古霉素耐药肠球菌定植率。4 CHG沐浴，通常与莫匹罗星和口服抗菌剂的鼻腔应用相结合，也被发现降低耐甲氧西林金黄色葡萄球菌（MRSA）的定植率和可能的获得率。虽然CHG是一种有前途的感染控制干预措施，但对CHG在医院外洗澡的效果的研究有限。MRSA曾被认为是唯一的医院病原体。然而，MRSA的流行病学已经发生了变化，它已经出现在社区环境中的个人没有以前的医疗保健暴露，所谓的社区相关MRSA（CA-MRSA）。尽管CA-MRSA可引起侵袭性疾病，如血流感染，但它主要引起皮肤和软组织感染（SSTI）。10几个不同的群体-新兵，11囚犯，12和业余和专业运动员13-已被确定为CA-MRSA定植和感染的风险增加，可能是因为拥挤或与其他人密切接触。新兵是研究感染控制干预的独特社区人群，因为他们拥挤的生活条件，洗澡的机会减少，割伤和擦伤的机会增加。14 CA-MRSA定植率在新兵中高于一般人群，16据报道，CA-MRSA SSTI在新兵中爆发。11因此，可能需要在这类人群中加强预防工作。
Chlorhexidine gluconate (CHG) is an antiseptic agent that has been used for multiple purposes including catheter insertion preparation and maintenance, 1 body antisepsis, 2 and application in the nasopharynx and oropharynx. 3 Antisepsis with this agent is believed to reduce colonization with potential pathogens," which in turn would lead theoretically to a reduction in the number of infections. Bathing medical intensive care unit patients with CHG cloths has been effective in reducing the rate of central venous catheter-associated bloodstream infections2, 5 and the rate of colonization with vancomycin-resistant Enterococcus. 4 CHG bathing, often in combination with nasal application of mupirocin and oral antimicrobial agents, also has been found to decrease rates of colonization with and possibly rates of acquisition of methicillin-resistant Staphylococcus aureus (MRSA). 6, 7 Although it is a promising infection control intervention, examination of the efficacy of CHG bathing outside of the hospital has been limited.MRSA was once considered to be solely a nosocomial pathogen. However, the epidemiology of MRSA has changed—it has emerged in community settings among individuals without prior healthcare exposures, so-called community-associated MRSA (CA-MRSA). 8 Although CA-MRSA can cause invasive disease, such as bloodstream infection, 9 it predominantly causes skin and soft-tissue infection (SSTI). 10 Several distinct groups—military recruits, 11 prisoners, 12 and amateur and professional athletes13—have been identified as being at increased risk for CA-MRSA colonization and infection, possibly because of crowding or close contact with other individuals. Military recruits are a unique community population for studying an infection control intervention, given their crowded living conditions, decreased access to bathing, and increased opportunity for cuts and abrasions. 14 CA-MRSA colonization rates have been found to be higher among military recruits15 than among the general population, 16 with outbreaks of CA-MRSA SSTIs among military recruits reported. 11 Therefore, enhanced prevention efforts in a population such as this may be needed.