PDF(Pubmed)
Abstract：
UNASSIGNED: Bacterial infections affect survival of patients with cirrhosis. Hospital-acquired bacterial infections present a growing healthcare problem because of the increasing prevalence of multidrug-resistant organisms. This study aimed to investigate the impact of an infection prevention and control programme and coronavirus disease 2019 (COVID-19) measures on the incidence of hospital-acquired infections and a set of secondary outcomes, including the prevalence of multidrug-resistant organisms, empiric antibiotic treatment failure, and development of septic states in patients with cirrhosis.
UNASSIGNED: The infection prevention and control programme was a complex strategy based on antimicrobial stewardship and the reduction of patient\'s exposure to risk factors. The COVID-19 measures presented further behavioural and hygiene restrictions imposed by the Hospital and Health Italian Sanitary System recommendations. We performed a combined retrospective and prospective study in which we compared the impact of extra measures against the hospital standard.
UNASSIGNED: We analysed data from 941 patients. The infection prevention and control programme was associated with a reduction in the incidence of hospital-acquired infections (17 vs. 8.9%, p <0.01). No further reduction was present after the COVID-19 measures had been imposed. The impact of the infection prevention and control programme remained significant even after controlling for the effects of confounding variables (odds ratio 0.44, 95% CI 0.26-0.73, p = 0.002). Furthermore, the adoption of the programme reduced the prevalence of multidrug-resistant organisms and decreased rates of empiric antibiotic treatment failure and the development of septic states.
UNASSIGNED: The infection prevention and control programme decreased the incidence of hospital-acquired infections by nearly 50%. Furthermore, the programme also reduced the prevalence of most of the secondary outcomes. Based on the results of this study, we encourage other liver centres to adopt infection prevention and control programmes.
UNASSIGNED: Infections are a life-threatening problem for patients with liver cirrhosis. Moreover, hospital-acquired infections are even more alarming owing to the high prevalence of multidrug-resistant bacteria. This study analysed a large cohort of hospitalised patients with cirrhosis from three different periods. Unlike in the first period, an infection prevention programme was applied in the second period, reducing the number of hospital-acquired infections and containing multidrug-resistant bacteria. In the third period, we imposed even more stringent measures to minimise the impact of the COVID-19 outbreak. However, these measures did not result in a further reduction in hospital-acquired infections.
UNASSIGNED: The infection prevention and control programme was a complex strategy based on antimicrobial stewardship and the reduction of patient\'s exposure to risk factors. The COVID-19 measures presented further behavioural and hygiene restrictions imposed by the Hospital and Health Italian Sanitary System recommendations. We performed a combined retrospective and prospective study in which we compared the impact of extra measures against the hospital standard.
UNASSIGNED: We analysed data from 941 patients. The infection prevention and control programme was associated with a reduction in the incidence of hospital-acquired infections (17 vs. 8.9%, p <0.01). No further reduction was present after the COVID-19 measures had been imposed. The impact of the infection prevention and control programme remained significant even after controlling for the effects of confounding variables (odds ratio 0.44, 95% CI 0.26-0.73, p = 0.002). Furthermore, the adoption of the programme reduced the prevalence of multidrug-resistant organisms and decreased rates of empiric antibiotic treatment failure and the development of septic states.
UNASSIGNED: The infection prevention and control programme decreased the incidence of hospital-acquired infections by nearly 50%. Furthermore, the programme also reduced the prevalence of most of the secondary outcomes. Based on the results of this study, we encourage other liver centres to adopt infection prevention and control programmes.
UNASSIGNED: Infections are a life-threatening problem for patients with liver cirrhosis. Moreover, hospital-acquired infections are even more alarming owing to the high prevalence of multidrug-resistant bacteria. This study analysed a large cohort of hospitalised patients with cirrhosis from three different periods. Unlike in the first period, an infection prevention programme was applied in the second period, reducing the number of hospital-acquired infections and containing multidrug-resistant bacteria. In the third period, we imposed even more stringent measures to minimise the impact of the COVID-19 outbreak. However, these measures did not result in a further reduction in hospital-acquired infections.
摘要：
未经证实：细菌感染会影响肝硬化患者的生存率。由于多药耐药生物的流行，医院获得性细菌感染带来了日益严重的医疗保健问题。本研究旨在调查感染预防和控制计划和COVID-19措施对医院获得性感染发生率和一系列次要结局的影响，包括多重耐药生物的流行，经验性抗生素治疗失败和肝硬化患者脓毒症状态的发展。
UASSIGNED：感染预防和控制计划是一项基于抗菌药物管理和减少患者暴露于危险因素的复杂策略。COVID-19措施提出了医院和卫生部意大利卫生系统建议实施的进一步行为和卫生限制。我们进行了一项回顾性和前瞻性联合研究，比较了额外措施与医院标准的影响。
UNASSIGNED：我们分析了941例患者的数据。感染预防和控制程序与医院获得性感染发生率的降低相关(17%vs.8.9%,p<0.01)。在实施COVID-19措施后，没有进一步减少。即使控制了混杂变量的影响，感染预防和控制程序的影响仍然显着（OR0.44，95％CI0.26-0.73，p=0.002）。此外，该计划的采用降低了多药耐药菌的患病率,并降低了经验性抗生素治疗失败和败血症状态的发生率.
UASSIGNED：感染预防和控制计划将医院获得性感染的发生率降低了近50％。此外，该计划还降低了大多数次要结局的患病率.根据这项研究的结果，我们鼓励其他肝脏中心采用感染预防和控制计划。
未经证实：感染是肝硬化患者的威胁生命的问题。此外，由于多重耐药细菌的高流行,医院获得性感染更加令人担忧.这项研究分析了来自三个不同时期的住院肝硬化患者的大量队列。与第一个相比，在第二阶段实施了感染预防计划，减少医院获得性感染的数量，并含有多重耐药细菌。在第三阶段，我们实施了更严格的措施，以最大限度地减少COVID-19疫情的影响。然而,这些措施并未导致医院获得性感染的进一步减少.
UASSIGNED：感染预防和控制计划是一项基于抗菌药物管理和减少患者暴露于危险因素的复杂策略。
UNASSIGNED：我们分析了941例患者的数据。
UASSIGNED：感染预防和控制计划将医院获得性感染的发生率降低了近50％。
未经证实：感染是肝硬化患者的威胁生命的问题。
