The I-STRAT trial: Do Isolation Strategies reduce endemic levels of MRSA and Clostridium difficle associated diarrhoea

I-STRAT 试验：隔离策略是否可以降低 MRSA 和艰难梭菌相关性腹泻的流行水平

• 批准号: G0701815/1
• 负责人: Sheldon Stone
• 金额: $ 53.99万
• 依托单位: University College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2008
• 资助国家: 英国
• 起止时间: 2008 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=G0701815%2F1
• 关键词: STRAT; trial; Do; Isolation; Strategies

What do most people fear about coming into hospital? Catching a superbug infection such as MRSA or Clostridium difficile! Despite a tranche of Government initiatives to reduce these, they appear rampant. Surely their control should be simple. Keep the hospitals clean! Make sure staff clean their hands! Put people with these infections into isolation straight away! However, it is this last intervention , isolation, that proves so difficult. Infection Control staff often bemoan the lack of effective isolation facilities. Managers say they cannot afford to make more isolation beds available, especially as there is no good evidence from a proper trial to prove this works. This study will get to the bottom of the difficulties in providing effective isolation. It will help Trusts, through a nationwide consultation, and intensive work with 25-30 trusts, to work out the barriers, at organizational and individual levels, to effective isolation. It will help them come up with ideas of how to make isolation facilities available and make the most of those facilities that they have. Trusts will be able to design the isolation policies they think most likely to work, a small number will ?test drive? these in a preliminary trial that can then be rolled out to a larger number of hospitals, to find the best way to reduce MRSA and Clostridium difficile through isolation.The two lead researchers in the I-STRAT trial, Barry Cookson and Sheldon Stone, say ?Nowhere in the world has looked at how best to make isolation work. Part of the reason for that is that there are so many difficulties in running a proper trial of this. People think that isolation may be expensive, or that is it hard to provide designated staff. No one is even sure exactly which patients should be isolated, or how we should measure success. This study is going to address these issues, working closely with Trusts, to help them come up with their own interventions to design a feasible ?mini-trial?. If that looks practical, then we could move to a full scale trial which might provide us with some definite answers about the role of isolation in fighting these so-called ?superbugs?

大多数人害怕进医院的原因是什么？感染超级细菌，如MRSA或艰难梭菌！尽管政府采取了一系列措施来减少这些现象，但这些现象似乎十分猖獗。他们的控制应该很简单。保持医院清洁！确保员工清洁双手！把这些感染的人立即隔离！然而，正是这最后的干预，孤立，证明是如此困难。感染控制工作人员经常抱怨缺乏有效的隔离设施。管理人员说，他们负担不起提供更多的隔离床，特别是因为没有来自适当试验的良好证据来证明这种做法有效。这项研究将深入了解提供有效隔离的困难。它将通过全国范围的协商和与25-30个信托基金的密集工作，帮助信托基金在组织和个人层面上消除有效隔离的障碍。这将帮助他们想出如何提供隔离设施的想法，并充分利用他们拥有的这些设施。信托公司将能够设计他们认为最有可能起作用的隔离政策，少数人会吗？试驾？I-STRAT试验的两名主要研究人员巴里库克森和谢尔顿斯通说：“我们正在进行一项初步试验，然后将其推广到更多的医院，以找到通过隔离减少MRSA和艰难梭菌的最佳方法。”世界上没有任何地方研究过如何最好地使隔离发挥作用。部分原因是，在进行适当的审判方面有很多困难。人们认为隔离可能很昂贵，或者很难提供指定的工作人员。甚至没有人确切地知道哪些患者应该被隔离，或者我们应该如何衡量成功。这项研究将解决这些问题，与信托公司密切合作，帮助他们想出自己的干预措施，设计一个可行的？小型审判？如果这看起来是可行的，那么我们就可以进行一次全面的试验，这可能会为我们提供一些关于孤立在打击这些所谓的？超级细菌