背景:目前,不同的指南建议使用不同的方法来确定在确定多药耐药生物体(MDRO)的检出率时是否需要重复数据删除.然而,很少有研究调查重复数据删除对MDRO监测数据的影响。在这项研究中,我们旨在研究重复数据删除对不同标本中MDROs检出率的影响,以评估其对感染监测结果的影响.
方法:从2022年1月至2022年12月期间收治的住院患者中收集样本;从关键监测的MDRO中收集四种类型的样本,包括痰样本,尿液样本,血液样本,和支气管肺泡灌洗液(BALF)样品。在这项研究中,我们比较和分析了耐碳青霉烯类肺炎克雷伯菌(CRKP)的检出率,耐碳青霉烯类大肠杆菌(CRECO),耐碳青霉烯类鲍曼不动杆菌(CRAB),耐碳青霉烯类铜绿假单胞菌(CRPA),和耐甲氧西林金黄色葡萄球菌(MRSA)在两种条件下:有和没有重复数据删除。
结果:当包括所有标本时,CRKP的检出率,CRAB,CRPA,和无重复数据删除的MRSA(33.52%,77.24%,44.56%,和56.58%,分别)显著高于重复数据删除的(24.78%,66.25%,36.24%,50.83%,分别)(均P<0.05)。痰标本中的检出率在没有重复的样本之间存在显着差异(28.39%,76.19%,46.95%,和70.43%)和具有重复数据删除的(19.99%,63.00%,38.05%,64.50%)(均P<0.05)。当不执行重复数据删除时,尿样中CRKP的检出率达30.05%,超过重复数据删除率(21.56%)(P<0.05)。在BALF标本中,CRKP和CRPA的检出率无重复数据(39.78%和53.23%,分别)高于重复数据删除率(31.62%和42.20%,分别)(P<0.05)。在血液样本中,重复数据删除对MDRO的检出率没有显著影响。
结论:重复数据删除对痰中MDRO的检出率有显著影响,尿液,和BALF样本。基于这些数据,我们呼吁感染预防和控制组织在监测MDRO检出率时,将其分析规则与细菌耐药性监测组织的分析规则保持一致。
BACKGROUND: Currently, different guidelines recommend using different methods to determine whether deduplication is necessary when determining the detection rates of multidrug-resistant organisms (MDROs). However, few studies have investigated the effect of deduplication on MDRO monitoring data. In this study, we aimed to investigate the influence of deduplication on the detection rates of MDROs in different specimens to assess its impact on infection surveillance outcomes.
METHODS: Samples were collected from hospitalized patients admitted between January 2022 and December 2022; four types of specimens were collected from key monitored MDROs, including sputum samples, urine samples, blood samples, and bronchoalveolar lavage fluid (BALF) samples. In this study, we compared and analysed the detection rates of carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Escherichia coli (CRECO), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and methicillin-resistant Staphylococcus aureus (MRSA) under two conditions: with and without deduplication.
RESULTS: When all specimens were included, the detection rates of CRKP, CRAB, CRPA, and MRSA without deduplication (33.52%, 77.24%, 44.56%, and 56.58%, respectively) were significantly greater than those with deduplication (24.78%, 66.25%, 36.24%, and 50.83%, respectively) (all P < 0.05). The detection rates in sputum samples were significantly different between samples without duplication (28.39%, 76.19%, 46.95%, and 70.43%) and those with deduplication (19.99%, 63.00%, 38.05%, and 64.50%) (all P < 0.05). When deduplication was not performed, the rate of detection of CRKP in urine samples reached 30.05%, surpassing the rate observed with deduplication (21.56%) (P < 0.05). In BALF specimens, the detection rates of CRKP and CRPA without deduplication (39.78% and 53.23%, respectively) were greater than those with deduplication (31.62% and 42.20%, respectively) (P < 0.05). In blood samples, deduplication did not have a significant impact on the detection rates of MDROs.
CONCLUSIONS: Deduplication had a significant effect on the detection rates of MDROs in sputum, urine, and BALF samples. Based on these data, we call for the Infection Prevention and Control Organization to align its analysis rules with those of the Bacterial Resistance Surveillance Organization when monitoring MDRO detection rates.