目的:评估消化道选择性净化(SDD)对需要进入烧伤病房(BU)的急性烧伤患者医院获得性感染(HAIs)的影响。
方法:回顾性前后队列研究,2017年1月至2023年6月。SDD于2019年3月实施,将患者分为两组。
方法:四床BU,在西班牙的一所大学医院转诊。
方法:研究期间收治的所有患者均符合分析条件。入院48小时内死亡或出院的病人,而未考虑全面升级治疗的估计生存率低于10%的患者被排除.
方法:SDD包括给予4天疗程的静脉注射抗生素,以及在BU逗留期间口服不可吸收抗生素的口服悬浮液和口服局部糊剂。
■在BU逗留期间HAIs的发生率。
结果:按部位划分的特定类型感染的发生率(菌血症,肺炎,皮肤和软组织感染)和微生物(革兰氏阳性,革兰氏阴性,真菌),和安全端点。
结果:我们分析了72例患者:27例未接受SDD,和45收到SDD。非SDD组和SDD组发生HAIs的患者分别为21例(77.8%)和21例(46.7%),分别(p=0.009)。医院感染发作次数分别为2.52(1.21-3.82)和1.13(0.54-1.73),分别(p=0.029)。
结论:SDD与每位患者的细菌性HAIs发生率降低和感染发作次数减少相关。
OBJECTIVE: To evaluate the effect of selective decontamination of the digestive tract (SDD) on hospital-acquired infections (HAIs) in patients with acute burn injury requiring admission to a Burns Unit (BU).
METHODS: Retrospective before-and-after cohort
study, between January 2017 and June 2023. SDD was implemented in March 2019, dividing patients into two groups.
METHODS: Four-bed BU, in a referral University Hospital in Spain.
METHODS: All the patients admitted during the
study period were eligible for analysis. Patients who died or were discharged within 48hours of admission, and patients with an estimated survival less than 10% not considered for full escalation of therapy were excluded.
METHODS: SDD comprised the administration of a 4-day course of an intravenous antibiotic, and an oral suspension and oral topical paste of non-absorbable antibiotics during the stay in the BU.
UNASSIGNED: Incidence of HAIs during the stay in the BU.
RESULTS: incidence of specific types of infections by site (bacteremia, pneumonia, skin and soft tissue infection) and microorganism (Gram-positive, Gram-negative, fungi), and safety endpoints.
RESULTS: We analyzed 72 patients: 27 did not receive SDD, and 45 received SDD. The number of patients who developed HAIs were 21 (77.8%) and 21 (46.7%) in the non-SDD and the SDD groups, respectively (p=0.009). The number of hospital-acquired infectious episodes were 2.52 (1.21-3.82) and 1.13 (0.54-1.73), respectively (p=0.029).
CONCLUSIONS: SDD was associated with a reduced incidence of bacterial HAIs and a decrease in the number of infectious episodes per patient.