PDF(Pubmed)
Abstract：
UNASSIGNED: The impact of environmental hygiene on the occurrence of hospital-acquired infections (HAIs) remains a subject of debate. We determined the effect of three different surface-cleaning strategies on the incidence of HAIs.
UNASSIGNED: Between June 2017 and August 2018 we conducted a pragmatic, cluster-randomized controlled crossover trial at 18 non-ICU wards in the university hospital of Berlin, Germany. Surfaces in patient rooms on the study wards were routinely cleaned using one of three agents: Soap-based (reference), disinfectant and probiotic. Each strategy was used on each ward for four consecutive months (4m-4m-4m). There was a one-month wash-in period at the beginning of the study and after each change in strategy. The order of strategies used was randomized for each ward. Primary outcome was the incidence of HAIs. The trial was registered with the German Clinical Trials Register, DRKS00012675.
UNASSIGNED: 13,896 admitted patients met the inclusion criteria, including 4708 in the soap-based (reference) arm, 4535 in the disinfectant arm and 4653 in the probiotic arm. In the reference group, the incidence density of HAIs was 2.31 per 1000 exposure days. The incidence density was similar in the disinfectant arm 2.21 cases per 1000 exposure days (IRR 0.95; 95% CI 0.69-1.31; p = 0.953) and the probiotic arm 2.21 cases per 1000 exposure days (IRR 0.96; 95% CI 0.69-1.32; p = 0.955).
UNASSIGNED: In non-ICU wards, routine surface disinfection proved not superior to soap-based or probiotic cleaning in terms of HAI prevention. Thus, probiotic cleaning could be an interesting alternative, especially in terms of environmental protection.
UNASSIGNED: Federal Ministry of Education and Research of Germany (03Z0818C). Bill and Melinda Gates Foundation (INV-004308).
UNASSIGNED: Between June 2017 and August 2018 we conducted a pragmatic, cluster-randomized controlled crossover trial at 18 non-ICU wards in the university hospital of Berlin, Germany. Surfaces in patient rooms on the study wards were routinely cleaned using one of three agents: Soap-based (reference), disinfectant and probiotic. Each strategy was used on each ward for four consecutive months (4m-4m-4m). There was a one-month wash-in period at the beginning of the study and after each change in strategy. The order of strategies used was randomized for each ward. Primary outcome was the incidence of HAIs. The trial was registered with the German Clinical Trials Register, DRKS00012675.
UNASSIGNED: 13,896 admitted patients met the inclusion criteria, including 4708 in the soap-based (reference) arm, 4535 in the disinfectant arm and 4653 in the probiotic arm. In the reference group, the incidence density of HAIs was 2.31 per 1000 exposure days. The incidence density was similar in the disinfectant arm 2.21 cases per 1000 exposure days (IRR 0.95; 95% CI 0.69-1.31; p = 0.953) and the probiotic arm 2.21 cases per 1000 exposure days (IRR 0.96; 95% CI 0.69-1.32; p = 0.955).
UNASSIGNED: In non-ICU wards, routine surface disinfection proved not superior to soap-based or probiotic cleaning in terms of HAI prevention. Thus, probiotic cleaning could be an interesting alternative, especially in terms of environmental protection.
UNASSIGNED: Federal Ministry of Education and Research of Germany (03Z0818C). Bill and Melinda Gates Foundation (INV-004308).
摘要：
■环境卫生对医院获得性感染（HAIs）发生的影响仍然是一个争论的话题。我们确定了三种不同的表面清洁策略对HAIs发生率的影响。
■在2017年6月至2018年8月之间，我们进行了务实的，柏林大学医院18个非ICU病房的集群随机对照交叉试验，德国。研究病房病房的患者房间的表面使用三种试剂之一进行常规清洁：基于肥皂的（参考），消毒剂和益生菌。每种策略在每个病房中连续使用四个月（4m-4m-4m）。在研究开始时和每次策略改变后都有一个月的洗入期。每个病房使用的策略顺序是随机的。主要结果是HAIs的发生率。该试验已在德国临床试验注册中心注册，DRKS00012675.
■13896名入院患者符合纳入标准，包括基于肥皂的（参考）臂中的4708，4535在消毒剂臂和4653在益生菌臂。在参考组中，HAIs的发生率密度为2.31/1000暴露日.消毒剂组每1000天暴露2.21例（IRR0.95；95％CI0.69-1.31；p=0.953）和益生菌组每1000天暴露2.21例（IRR0.96；95％CI0.69-1.32；p=0.955）的发生率密度相似。
■在非ICU病房，在预防HAI方面，常规表面消毒并不优于肥皂或益生菌清洁。因此，益生菌清洁可能是一个有趣的选择，特别是在环境保护方面。
■德国联邦教育与研究部(03Z0818C)。比尔和梅琳达·盖茨基金会(INV-004308)。
■在2017年6月至2018年8月之间，我们进行了务实的，柏林大学医院18个非ICU病房的集群随机对照交叉试验，德国。研究病房病房的患者房间的表面使用三种试剂之一进行常规清洁：基于肥皂的（参考），消毒剂和益生菌。每种策略在每个病房中连续使用四个月（4m-4m-4m）。在研究开始时和每次策略改变后都有一个月的洗入期。每个病房使用的策略顺序是随机的。主要结果是HAIs的发生率。该试验已在德国临床试验注册中心注册，DRKS00012675.
■13896名入院患者符合纳入标准，包括基于肥皂的（参考）臂中的4708，4535在消毒剂臂和4653在益生菌臂。在参考组中，HAIs的发生率密度为2.31/1000暴露日.消毒剂组每1000天暴露2.21例（IRR0.95；95％CI0.69-1.31；p=0.953）和益生菌组每1000天暴露2.21例（IRR0.96；95％CI0.69-1.32；p=0.955）的发生率密度相似。
■在非ICU病房，在预防HAI方面，常规表面消毒并不优于肥皂或益生菌清洁。因此，益生菌清洁可能是一个有趣的选择，特别是在环境保护方面。
■德国联邦教育与研究部(03Z0818C)。比尔和梅琳达·盖茨基金会(INV-004308)。
