Use of WHONET-SaTScan system for simulated real-time detection of antimicrobial resistance clusters in a hospital in Italy, 2012 to 2014
Use of WHONET-SaTScan system for simulated real-time detection of antimicrobial resistance clusters in a hospital in Italy, 2012 to 2014
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DOI：
10.2807/1560-7917.es.2017.22.11.30484
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发表时间：
2017-03-16
期刊：
影响因子：
19
通讯作者：
D'Ancona, F.
中科院分区：
文献类型：
--
作者：
Natale, A.;Stelling, J.;D'Ancona, F.
耐药病原体感染在医疗保健环境中导致更高的患者死亡率、更长的住院时间和更高的治疗成本。加强和协调地方、国家和国际监测系统是控制抗菌素耐药性（AMR）的基石。在这项研究中，WHONET-SaTScan软件应用于意大利的一家医院，以确定潜在的AMR暴发。从国家抗菌素耐药性监测系统（AR-ISS）中提取了2012年至2014年罗马San Filippo Neri医院的数据，并使用WHONETSaTScan软件中包含的实时聚类检测模拟前瞻性分析进行了分析。结果与医院感染预防控制系统进行比较。WHONET-SaTScan确定了71个具有统计学意义的集群，其中一些涉及携带多种耐药表型的病原体。在这71例中，医院系统也检测到了3例，而仅由WHONET-SaTScan检测到的另外15例被认为具有相关重要性，值得医院感染控制小组进一步调查。在本研究中，WHONET-SaTScan系统首次应用于意大利的AMR监测，作为加强监测的工具，使用意大利国家监测系统定期收集的数据，在地方和国家层面制定更及时的干预策略。
Resistant pathogens infections cause in healthcare settings, higher patient mortality, longer hospitalisation times and higher costs for treatments. Strengthening and coordinating local, national and international surveillance systems is the cornerstone for the control of antimicrobial resistance (AMR). In this study, the WHONET-SaTScan software was applied in a hospital in Italy to identify potential outbreaks of AMR. Data from San Filippo Neri Hospital in Rome between 2012 and 2014 were extracted from the national surveillance system for antimicrobial resistance (AR-ISS) and analysed using the simulated prospective analysis for real-time cluster detection included in the WHONETSaTScan software. Results were compared with the hospital infection prevention and control system. The WHONET-SaTScan identified 71 statistically significant clusters, some involving pathogens carrying multiple resistance phenotypes. Of these 71, three were also detected by the hospital system, while a further 15, detected by WHONET-SaTScan only, were considered of relevant importance and worth further investigation by the hospital infection control team. In this study, the WHONET-SaTScan system was applied for the first time to the surveillance of AMR in Italy as a tool to strengthen this surveillance to allow more timely intervention strategies both at local and national level, using data regularly collected by the Italian national surveillance system.