PDF(Pubmed)
Abstract：
UNASSIGNED: A widely-accepted standardized preventive bundle targeting multidrug-resistant organisms (MDROs) is lacking. The objective was to describe the components, implementation, compliance, and impact of a novel MDROs bundle in intensive care units (ICUs).
UNASSIGNED: Cohort study of surveillance activities on the components of MDROs bundle (July 2019 to June 2022) and the incidence of MDROs (April 2016 to June 2022). The implementation of MDROs bundle were preceded by ICPs-led education of the staff working in target ICUs about the importance and components of the MDROs bundle. These included the overall use of antimicrobials, appropriate environmental cleaning, appropriate contact precautions, and hand hygiene compliance.
UNASSIGNED: During implementation, the overall use of antimicrobials was 57.8 days of therapy per 100 patient-days (44,492/76,933). It was higher in adult compared with pediatric/neonatal ICUs (p < 0.001). Appropriate environmental cleaning was 74.8% (12,409/16,582), appropriate contact precautions was 83.8% (10,467/12,497), and hand hygiene compliance was 86.9% (27,023/31,096). The three components were significantly higher in pediatric/neonatal compared with adult ICUs (p = 0.027, p < 0.001, p = 0.006, respectively). The MDROs rates per 10,000 patient-days were 71.8 before (April 2016 to June 2019) and 62.0 during (July 2019 to June 2022) the bundle implementation (858/119,565 versus 891/143,649 p = 0.002). The reduction in MDROs rates were replicated in adult (p = 0.001) but not pediatric/neonatal ICUs (p = 0.530).
UNASSIGNED: The finding of this study indicate that the implementation of the current bundle was associated with a modest decrease in MDROs rates in adult ICUs. The provided detailed definitions and methodology will facilitate its use by other healthcare facilities.
UNASSIGNED: Cohort study of surveillance activities on the components of MDROs bundle (July 2019 to June 2022) and the incidence of MDROs (April 2016 to June 2022). The implementation of MDROs bundle were preceded by ICPs-led education of the staff working in target ICUs about the importance and components of the MDROs bundle. These included the overall use of antimicrobials, appropriate environmental cleaning, appropriate contact precautions, and hand hygiene compliance.
UNASSIGNED: During implementation, the overall use of antimicrobials was 57.8 days of therapy per 100 patient-days (44,492/76,933). It was higher in adult compared with pediatric/neonatal ICUs (p < 0.001). Appropriate environmental cleaning was 74.8% (12,409/16,582), appropriate contact precautions was 83.8% (10,467/12,497), and hand hygiene compliance was 86.9% (27,023/31,096). The three components were significantly higher in pediatric/neonatal compared with adult ICUs (p = 0.027, p < 0.001, p = 0.006, respectively). The MDROs rates per 10,000 patient-days were 71.8 before (April 2016 to June 2019) and 62.0 during (July 2019 to June 2022) the bundle implementation (858/119,565 versus 891/143,649 p = 0.002). The reduction in MDROs rates were replicated in adult (p = 0.001) but not pediatric/neonatal ICUs (p = 0.530).
UNASSIGNED: The finding of this study indicate that the implementation of the current bundle was associated with a modest decrease in MDROs rates in adult ICUs. The provided detailed definitions and methodology will facilitate its use by other healthcare facilities.
摘要：
■缺乏广泛接受的针对多药耐药生物（MDRO）的标准化预防束。目的是描述组件，实施，合规,以及重症监护病房(ICU)中新型MDRO捆绑包的影响。
■关于MDROs束组成部分（2019年7月至2022年6月）和MDROs发生率（2016年4月至2022年6月）的监测活动的队列研究。在实施MDRO捆绑包之前，由ICPs主导，对目标ICU的工作人员进行了有关MDRO捆绑包的重要性和组成部分的教育。这些包括抗菌药物的整体使用，适当的环境清洁，适当的接触预防措施,和手部卫生依从性。
■在实施过程中，抗菌药物的总体使用为每100例患者治疗天数57.8天(44,492/76,933).与儿科/新生儿ICU相比，成人的发病率更高（p<0.001）。适当的环境清洁率为74.8%(12,409/16,582)，适当的接触预防措施为83.8%(10,467/12,497)，手卫生依从性为86.9%(27,023/31,096)。与成人ICU相比，儿科/新生儿中的三种成分显着升高（分别为p=0.027，p<0.001，p=0.006）。在捆绑实施之前（2016年4月至2019年6月）和期间（2019年7月至2022年6月），每10,000患者日的MDRO率为71.8，而在捆绑实施期间（2019年7月至2022年6月）为62.0（858/119,565对891/143,649p=0.002）。MDROs发生率的降低在成人中重复（p=0.001），而不是儿科/新生儿ICU（p=0.530）。
■这项研究的发现表明，当前捆绑的实施与成人ICU中MDRO率的适度下降有关。提供的详细定义和方法将有助于其他医疗机构使用。
■关于MDROs束组成部分（2019年7月至2022年6月）和MDROs发生率（2016年4月至2022年6月）的监测活动的队列研究。在实施MDRO捆绑包之前，由ICPs主导，对目标ICU的工作人员进行了有关MDRO捆绑包的重要性和组成部分的教育。这些包括抗菌药物的整体使用，适当的环境清洁，适当的接触预防措施,和手部卫生依从性。
■在实施过程中，抗菌药物的总体使用为每100例患者治疗天数57.8天(44,492/76,933).与儿科/新生儿ICU相比，成人的发病率更高（p<0.001）。适当的环境清洁率为74.8%(12,409/16,582)，适当的接触预防措施为83.8%(10,467/12,497)，手卫生依从性为86.9%(27,023/31,096)。与成人ICU相比，儿科/新生儿中的三种成分显着升高（分别为p=0.027，p<0.001，p=0.006）。在捆绑实施之前（2016年4月至2019年6月）和期间（2019年7月至2022年6月），每10,000患者日的MDRO率为71.8，而在捆绑实施期间（2019年7月至2022年6月）为62.0（858/119,565对891/143,649p=0.002）。MDROs发生率的降低在成人中重复（p=0.001），而不是儿科/新生儿ICU（p=0.530）。
■这项研究的发现表明，当前捆绑的实施与成人ICU中MDRO率的适度下降有关。提供的详细定义和方法将有助于其他医疗机构使用。
