华西医学

华西医学

防控产耐碳青霉烯酶的肠杆菌科细菌新观点

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产碳青霉烯酶的肠杆菌科细菌(carbapenemase producing Enterobacteriaceae,CPE)已成为全球公共卫生的一项重大挑战,可能将感染患者置于无法医治的风险中。由于对碳青霉烯类抗菌药物耐药,可用治疗方法常常极为有限。为了防止 CPE 在医疗机构中的出现和传播,许多国际指南在循证医学的基础上提出了新的防控策略。该文介绍了一些已被证明有效的防控关键策略:首先是通过主动筛查,尽早识别 CPE 携带者;在等待微生物筛查结果时,疑似 CPE 携带者在单人病房进行预防性隔离,同时医务人员执行接触预防措施。主动的监测培养和及时的预防性隔离将限制 CPE 在医院内的出现和传播。其次,整合强化院内基础感染防控措施的最佳实践至关重要,包括全面实施手卫生、正确使用个人防护用品、通过抗菌药物管理减少抗菌药物滥用、有效的环境清洁和消毒、员工教育和反馈、开展医院感染监测。这种整体方法能有效减少 CPE 在医疗机构内的立足点。

关键词: 产碳青霉烯酶的肠杆菌科细菌; 感染防控; 早识别; 预隔离

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