Hiệu quả của chương trình phòng ngừa trong phòng ngừa nhiễm khuẩn bệnh viện do vi khuẩn kháng mở rộng hoặc toàn kháng=The effectiveness of infection control program with extensively-drug-resistant or pan-drug-resistant bacteria in preventing hospital-acquired infections

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Tác giả: Thị Yến Bùi, Xuân Quảng Đoàn, Thị Mơ Ngô, Hải Phương Nguyễn, Trung Đình Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.109-116

Bộ sưu tập: Metadata

ID: 243465

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Nghiên cứu này nhằm đánh giá hiệu quả của việc cách ly bệnh nhân bị nhiễm khuẩn kháng mở rộng (XDR) hoặc toàn kháng (PDR) trong việc phòng ngừa nhiễm khuẩn bệnh viện. Đối tượng và phương pháp: Thiết kế nghiên cứu chuỗi thời gian ngắt quãng được sử dụng để đánh giá tác động của can thiệp. Thu thập dữ liệu bao gồm kết quả vi sinh và thông tin bệnh nhân, đồng thời phân tích bao gồm số liệu thống kê mô tả và phân tích, bao gồm phân tích chuỗi thời gian ngắt quãng. Kết quả: Nghiên cứu bắt đầu từ tháng 04 đến tháng 08 năm 2023, bao gồm 385 bệnh nhân bị nhiễm vi khuẩn kháng mở rộng (XDR)/toàn kháng (PDR). Hầu hết bệnh nhân là người cao tuổi (tuổi trung bình: 73 ± 15,7), với 81,6% từ 60 tuổi trở lên và 57,4% là nam giới. Tỷ lệ tử vong/nặng về ở những bệnh nhân này là 20%. Vi khuẩn Gram âm, đặc biệt là Klebsiella pneumoniae, Acinetobacter baumannii và Pseudomonas aeruginosa, chiếm phần lớn các trường hợp XDR/PDR. Tỷ lệ tiết ESBL (Extends Spectrum Beta-Lactamase) rất khác nhau, ở chủng XDR có tỷ lệ cao hơn so với chủng PDR. Một biện pháp can thiệp được đưa ra vào tháng 5 năm 2023 liên quan đến việc cách ly bệnh nhân và tăng cường tuân thủ vệ sinh tay đã giúp tỷ lệ nhiễm khuẩn do vi khuẩn XDR/PDR gây ra giảm 1,7% mỗi tuần. Kết luận: Sự can thiệp, bao gồm cách ly bệnh nhân và tăng cường tuân thủ vệ sinh tay, đã làm giảm hiệu quả các ca nhiễm khuẩn bệnh viện do vi khuẩn PDR/XDR gây ra. Điều này chứng tỏ tiềm năng của nó trong việc giảm thiểu sự lây lan của các sinh vật kháng thuốc này trong môi trường bệnh viện.This study aimed to evaluate the effectiveness of infection control programs with extensively drug-resistant (XDR) or pan drug-resistant (PDR) bacteria in preventing hospital-acquired infections. Methods: An interrupted time series design was employed to assess the intervention's impact. Data collection included microbiological results and patient information, and analysis involved descriptive and analytical statistics, including interrupted time-series analysis. Results: The study spanned from April to August 2023, involving 385 patients infected with XDR/PDR bacteria. Most patients were elderly (average age: 73 ± 15.7), with 81.6% aged 60 or older, and 57.4% were male. The mortality rate among these patients was 20.3%, with more than half experiencing recovery or improvement. Gram-negative bacteria, particularly Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, constituted the majority of XDR/PDR cases. The rate of ESBL (Extended Spectrum Beta-Lactamase) production varied, with higher rates in XDR strains compared to PDR strains. An intervention introduced in May 2023 involving patient isolation and enhanced hand hygiene compliance led to a weekly decrease of 1.7% in the infection rate caused by XDR/PDR bacteria. Conclusion: The intervention, including patient isolation and enhanced hand hygiene compliance, effectively reduced hospital-acquired infections caused by PDR/XDR bacteria. This demonstrates its potential to mitigate the spread of these drug-resistant organisms in a hospital environment.

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