背景:对艰难梭菌感染(CDI)诊断和临床治疗的国际指南的认识和遵守情况尚不清楚。
目的:比较2018-2019年欧洲CDI诊断和临床管理推荐策略的认知和依从性。
方法:12个欧洲国家的医院及其相关社区实践在2018-2019年完成了一项在线调查,以报告其在监测方面的实践。预防,诊断,和CDI的治疗。从105家医院和39名社区全科医生(GP)收集了答复。
结果:有11个国家的医院站点报告参与了国家监测计划,而有6个国家参与了国际监测计划。欧洲临床微生物学和传染病学会(ESCMID)推荐的CDI测试方法被82%(86/105)的医院使用。然而,报告CDI发生率最高的国家使用了非推荐的检测.超过75%(80/105)的医院在本次调查时知道最新的欧洲CDI治疗指南,而接受调查的全科医生只有26%(10/39)。然而,高达15%(16/105)的医院报告使用非推荐的甲硝唑治疗复发性CDI病例,对CDI治疗指南认识较低的国家的网站。只有37%(39/105)的医院在怀疑CDI的情况下采取了接触隔离预防措施。
结论:在接受调查的欧洲医院站点中观察到对CDI管理指南的良好认识。然而,低符合诊断测试指南,疑似CDI的感染控制措施,一些国家继续报告对治疗指南的认识不足。
BACKGROUND: Awareness and compliance with international
guidelines for diagnosis and clinical management of Clostridioides difficile infection (CDI) are unknown.
OBJECTIVE: To compare the awareness and compliance with the recommended strategies for diagnosis and clinical management of CDI across Europe in 2018-2019.
METHODS: Hospital sites and their associated community practices across 12 European countries completed an online survey in 2018-2019, to report on their practices in terms of surveillance, prevention, diagnosis, and treatment of CDI. Responses were collected from 105 hospitals and 39 community general practitioners (GPs).
RESULTS: Hospital sites of 11 countries reported participation in national surveillance schemes compared with six countries for international schemes. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID)-recommended CDI testing methodologies were used by 82% (86/105) of hospitals, however countries reporting the highest incidence of CDI used non-recommended tests. Over 75% (80/105) of hospitals were aware of the most recent European CDI treatment
guidelines at the time of this survey compared with only 26% (10/39) of surveyed GPs. However, up to 15% (16/105) of hospitals reported using the non-recommended metronidazole for recurrent CDI cases, sites in countries with lower awareness of CDI treatment guidelines. Only 37% (39/105) of hospitals adopted contact isolation precautions in case of suspected CDI.
CONCLUSIONS: Good awareness of
guidelines for the management of CDI was observed across the surveyed European hospital sites. However, low compliance with diagnostic testing
guidelines, infection control measures for suspected CDI, and insufficient awareness of treatment
guidelines continued to be reported in some countries.