Infection rate and colonization with antibiotic-resistant organisms in skilled nursing facility residents with indwelling devices.
Infection rate and colonization with antibiotic-resistant organisms in skilled nursing facility residents with indwelling devices.
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DOI：
10.1007/s10096-011-1504-7
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发表时间：
2012-08
影响因子：
4.5
通讯作者：
Mody, L.
中科院分区：
文献类型：
--
作者：
Wang, L.;Lansing, B.;Symons, K.;Flannery, E. L.;Fisch, J.;Cherian, K.;McNamara, S. E.;Mody, L.
这项前瞻性监测研究的目的是量化熟练护理机构 (SNF) 居民中耐药微生物 (ARO) 的定植和留置装置引起的感染。该研究在密歇根州东南部的 15 个 SNF 进行。对有（n = 90）和没有（n = 88）留置装置的居民进行了登记并随访了 907 个居民月。每月对多个解剖部位的居民进行培养，并获得感染数据。通过从非设备组的感染率减去设备组的感染率来计算设备归因率。研究期间共新增感染病例197例；设备组中有 87 例感染（发病率 [IR] = 331/1,000 住院月），非设备组有 110 例感染（IR = 171/1,000 住院月），相对风险为 1.9（95% 置信区间 [CI]：1.4–2.6）。设备组居民中过度感染的归因率为 160/1,000 居民月，归因比例为 48%（95% CI：31-61%）。与无设备组相比，设备组中所有 ARO 的患病率均较高。每 1,000 名居民培养的 ARO 数量从无装置增加到只有饲管的人，其次是只有导尿管和两种装置的人。总之，留置装置的存在与较高的感染发生率和 ARO 患病率相关。我们的研究量化了这种风险，并表明使用留置装置的 SNF 居民中大约一半的感染可以通过移除装置来消除。需要采取有效的策略来减少这些居民的感染和 ARO。
The objective of this prospective surveillance study was to quantify colonization with antimicrobial-resistant organisms (AROs) and infections attributable to indwelling devices in skilled nursing facility (SNF) residents. The study was conducted in 15 SNFs in Southeast Michigan. Residents with (n = 90) and without (n = 88) an indwelling device were enrolled and followed for 907 resident-months. Residents were cultured monthly from multiple anatomic sites and data on infections were obtained. The device-attributable rate was calculated by subtracting the infection rate in the device group from the infection rate in the non-device group. A total of 197 new infections occurred during the study period; 87 in the device group (incidence rate [IR] = 331/1,000 resident-months) and 110 infections in the non-device group (IR = 171/1,000 resident-months), with a relative risk of 1.9 (95% confidence interval [CI]: 1.4–2.6). The attributable rate of excess infections among residents in the device group was 160/1,000 resident-months, with an attributable fraction of 48% (95% CI: 31–61%). Prevalence rates for all AROs were higher in the device group compared with the no-device group. The prevalence of the number of AROs per 1,000 residents cultured increased from no-device to those with only feeding tubes, followed by those with only urinary catheters and both these devices. In conclusion, the presence of indwelling devices is associated with higher incidence rates for infections and prevalence rates for AROs. Our study quantifies this risk and shows that approximately half of all infections in SNF residents with indwelling devices can be eliminated with device removal. Effective strategies to reduce infections and AROs in these residents are warranted.
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影响因子：
4.5
作者：
Benenson, Shmuel;Cohen, Matan J.;Moses, Allon E.
通讯作者：
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影响因子：
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作者：
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作者：
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Donskey, CJ