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Methods to assess environmental surface disinfectants against viruses: the quest and recommendations for a globally harmonized approach to microbicide testing 评估环境表面消毒剂抗病毒能力的方法:寻求和建议全球统一的杀微生物剂测试方法
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-08-29 DOI: 10.1016/j.infpip.2024.100395
Syed A. Sattar , Bahram Zargar , Jason Tetro

Viruses pose a wide-ranging and significant risk to human health through acute and persistent infections that may confer risks for sequelae including musculoskeletal, immunological, and oncological disease. Infection prevention and control (IPAC) remains a highly effective, generic, global, and cost-effective means to mitigate virus spread. IPAC recommends proper disinfection of high-touch environmental surfaces (HITES) to reduce the risk of direct and indirect virus spread. The United States, Canada and many other countries mandate pre-market assessments of HITES disinfectants against viruses and other types of microbial pathogens. However, there are basic disparities in the regulation of disinfectants. Such incongruity in test protocols interferes with the determination of the true breadth of the microbicidal potential of a given product in the field where target pathogens are often unknown or may be encountered as mixtures. This review examines the various methodological disparities and recommends a more cohesive and harmonized approach. While there is particular emphasis on viruses here, an overall harmonization in microbicide testing of HITES disinfectants will greatly assist the numerous stakeholders involved in IPAC.

病毒通过急性和持续性感染对人类健康构成广泛而重大的风险,可能带来后遗症风险,包括肌肉骨骼、免疫和肿瘤疾病。感染预防与控制(IPAC)仍然是一种高效、通用、全球性和具有成本效益的减少病毒传播的手段。IPAC 建议对高接触环境表面(HITES)进行适当消毒,以降低病毒直接和间接传播的风险。美国、加拿大和许多其他国家强制要求对高接触环境表面消毒剂针对病毒和其他类型的微生物病原体进行上市前评估。然而,消毒剂的监管存在基本差异。在目标病原体往往未知或可能以混合物形式出现的情况下,测试协议中的这种不一致干扰了在现场确定特定产品杀微生物潜力的真正广度。本综述对各种方法上的差异进行了研究,并建议采用一种更具凝聚力和协调性的方法。虽然本文特别强调病毒,但 HITES 消毒剂杀微生物测试的整体协调将极大地帮助 IPAC 的众多利益相关者。
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引用次数: 0
Performance of an Autonomous Sanitary Sterilisation Ultraviolet Machine (ASSUM) on terminal disinfection of surgical theaters and rooms of an intensive-intermediate care unit 自主卫生消毒紫外线机(ASSUM)在手术室和重症-中度护理病房的终端消毒方面的性能
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-08-29 DOI: 10.1016/j.infpip.2024.100396
Sabina Herrera , Ignasi Roca , Ana Del Río , Javier Fernández , Cristina Pitart , Isabel Fortes , Blanca Torralbo , Gemina Santana , Romina Parejo-González , Andreu Veà-Baró , Josep Maria Campistol , Mireia Aguilar , Sergi Degea , Climent Casals-Pascual , Alex Soriano , José A. Martínez

Background

Ultraviolet- C (UV–C) light is effective for reducing environmental bioburden in hospitals, and the use of robots to deliver it may be advantageous.

Aim

To evaluate the feasibility and clinical efficacy of an autonomous programmable UV-C robot in surgical and intensive care unit (ICU) rooms of a tertiary hospital.

Method

During ten consecutive months, the device was used in six theatres where cardiac, colorectal and orthopaedic surgeries were performed, and in the rooms previously occupied by patients subjected to contact precautions of a 14-bed ICU. Surgical site infection (SSI) rates of procedures performed in the UV-cleaned theatres were compared with those of the previous year. Incidence in clinical samples of ICU-acquired multiple-drug resistant (MDR) microorganisms was compared with that of the same period of the previous year. An UV-C exposure study done by semi-quantitative dosimeters and a survey of the bioburden on surfaces were carried out.

Findings

SSI rates in the pre- and post-intervention periods were 8.67% (80/922) and 7.5% (61/813), respectively (p=0.37). Incidence of target microorganisms in clinical samples remained unchanged (38.4 vs. 39.4 per 10,000 patient-days, p=0.94). All the dosimeters exposed to ≤1 meter received ≥500 mJ/cm2. The bacterial load on surfaces decreased after the intervention, particularly in ICU rooms (from 4.57±7.4 CFU to 0.27±0.8 CFU, p<0.0001).

Conclusion

Deployment of an UV-C robot in surgical and ICU rooms is feasible, ensures adequate delivery of germicidal UV-C light and reduces the environmental bacterial burden. Rates of surgical site infections or acquisition of MDR in clinical samples of critically-ill patients remained unchanged.

背景紫外线-C(UV-C)光可有效减少医院的环境生物负荷,使用机器人提供紫外线-C光可能具有优势。 目的评估在一家三级医院的手术室和重症监护室(ICU)病房使用自主可编程紫外线-C机器人的可行性和临床疗效。方法在连续十个月内,在六间进行心脏、结肠直肠和骨科手术的手术室以及拥有 14 张床位的重症监护室中以前由接触性预防措施病人占用的房间中使用该设备。在紫外线清洁过的手术室中进行的手术的手术部位感染率(SSI)与前一年的感染率进行了比较。将重症监护室获得的多重耐药(MDR)微生物临床样本的发生率与上一年同期进行了比较。通过半定量剂量计进行了紫外线照射研究,并对表面的生物负载进行了调查。干预前后的感染率分别为 8.67%(80/922)和 7.5%(61/813)(P=0.37)。临床样本中目标微生物的发生率保持不变(38.4 vs. 39.4 per 10,000 patient-days,p=0.94)。所有照射量≤1 米的剂量计都接收了≥500 mJ/cm2。结论在手术室和重症监护室部署紫外线 C 波段机器人是可行的,它能确保提供足够的紫外线 C 波段杀菌光,并减少环境中的细菌负担。在重症患者的临床样本中,手术部位感染或获得 MDR 的比率保持不变。
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引用次数: 0
An assessment of infection prevention and control implementation in Malawian hospitals using the WHO Infection Prevention and Control Assessment Framework (IPCAF) tool 利用世界卫生组织感染预防与控制评估框架(IPCAF)工具评估马拉维医院的感染预防与控制实施情况
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-08-22 DOI: 10.1016/j.infpip.2024.100388
Dorica Ng'ambi , Thomasena O'Byrne , Emmie Jingini , Hope Chadwala , Owen Musopole , Wala Kamchedzera , Tara Tancred , Nicholas Feasey

Background

Infection prevention and control (IPC) is important for the reduction of healthcare-associated infections (HAI). The World Health Organization (WHO) developed the IPC Assessment Framework (IPCAF) tool to assess the level of IPC implementation and to identify areas for improvement in healthcare facilities.

Methods

A cross -sectional survey was conducted using the WHO IPCAF tool from May to June 2023. The aim was to provide a baseline assessment of the IPC programme and activities within health care facilities in Malawi. Forty healthcare facilities were invited to participate. IPC teams were requested to complete the IPCAF and return the scores. The IPCAF tool scores were assessed as recommended in the WHO IPCAF tool.

Results

The response rate was 82.5%. The median IPCAF score was 445 out of 800 corresponding to an intermediate IPC implementation level. The results revealed that 66.7% facilities were at intermediate level, 26.4% at basic level, and 6.9% at advanced level. Most facilities (76%) had an IPC program in place with clear objectives and an IPC focal person. Few had a dedicated budget for IPC. The IPCAF domain “monitoring/audit of IPC practices and feedback” had the lowest median score of 15/100, and in 90% of facilities, no monitoring, audit, and feedback was done. HAI surveillance median score was 40/100, workload, staffing and bed occupancy median score was 45/100.

Conclusions

Whilst there has been some degree of implementation of WHO IPC guidelines in Malawi's healthcare system, there is significant room for improvement. The IPCAF tool revealed that monitoring/audit and feedback, HAI surveillance and workload, staffing and bed occupancy need to be strengthened. The IPCAF scoring system may need reconsidering given the centrality of these domains to IPC.

背景感染预防与控制(IPC)对于减少医疗相关感染(HAI)非常重要。世界卫生组织(WHO)开发了IPC评估框架(IPCAF)工具,用于评估医疗机构实施IPC的水平,并确定需要改进的领域。目的是对马拉维医疗机构的 IPC 计划和活动进行基线评估。40 家医疗机构应邀参加了调查。要求 IPC 小组完成 IPCAF 并交回分数。按照世界卫生组织 IPCAF 工具的建议,对 IPCAF 工具得分进行了评估。IPCAF 分数的中位数为 445 分(满分 800 分),处于 IPC 实施的中等水平。结果显示,66.7%的机构处于中级水平,26.4%处于基础水平,6.9%处于高级水平。大多数医疗机构(76%)都制定了 IPC 计划,并有明确的目标和 IPC 联络人。很少有机构为 IPC 划拨了专项预算。IPCAF领域 "IPC实践的监测/审计和反馈 "的中位数得分最低,仅为15/100,90%的机构没有进行监测、审计和反馈。HAI 监测的中位数得分为 40/100,工作量、人员配备和床位占用率的中位数得分为 45/100。IPCAF 工具显示,监测/审计和反馈、HAI 监测和工作量、人员配备和床位占用率需要加强。鉴于这些领域对 IPC 的核心作用,IPCAF 评分系统可能需要重新考虑。
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引用次数: 0
Device associated healthcare associated infection (DA-HAI): a detailed analysis of risk factors and outcomes in a university hospital in Rome, Italy 设备相关医护相关感染(DA-HAI):意大利罗马一所大学医院的风险因素和结果详细分析
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-08-18 DOI: 10.1016/j.infpip.2024.100391
Luca Guarente , Claudia Mosconi , Mariagrazia Cicala , Carolina De Santo , Fausto Ciccacci , Mariachiara Carestia , Leonardo Emberti Gialloreti , Leonardo Palombi , Giuseppe Quintavalle , Daniele Di Giovanni , Ersilia Buonomo , Stefania Moramarco , Fabio Riccardi , Stefano Orlando

Introduction

This study investigates the impact of invasive procedures on healthcare-associated infections (HAI) at Policlinico Universitario Tor Vergata in Rome, Italy, aiming to understand their role in device-associated HAI and to inform prevention strategies.

Methods

A retrospective cohort analysis was conducted, examining mandatory discharge records and microbiology data from 2018 across all departments. The study focused on adult patients, analysing the correlation between invasive procedures and HAI through univariate and multivariate logistic regression.

Results

Of the 12,066 patients reviewed, 1,214 (10.1%) experienced HAI. Univariate analysis indicated an association between invasive procedures and HAI (OR = 1.81, P < 0.001), which was not observed in multivariable analysis. Specific procedures significantly raised HAI risks: temporary tracheostomy (AOR = 22.69, P <0.001), central venous pressure monitoring (AOR = 6.74, P <0.001) prolonged invasive mechanical ventilation (AOR = 4.44, P <0.001), and venous catheterisation (AOR = 1.58, P <0.05). Aggregated high-risk procedures had an increased likelihood of HAI in multivariable analysis (OR = 2.51, P < 0.001). High-risk departments were also notably associated with HAI (OR = 6.13, P < 0.001).

Conclusions

This study suggests that specific invasive procedures, such as temporary tracheostomy, significantly increase HAI risks. The results highlighting the need for targeted infection prevention and control procedures and supports the need for innovative methods such as record-linkage in policymaking to address HAI. These findings inform clinical practice and healthcare policy to improve patient safety and care quality.

导言本研究调查了意大利罗马 Tor Vergata Policlinico Universitario 大学的侵入性程序对医疗相关感染(HAI)的影响,旨在了解侵入性程序在器械相关 HAI 中的作用,并为预防策略提供参考。方法进行了回顾性队列分析,检查了所有科室 2018 年的强制出院记录和微生物学数据。研究以成年患者为重点,通过单变量和多变量逻辑回归分析了侵入性程序与 HAI 之间的相关性。单变量分析表明,侵入性手术与 HAI 存在关联(OR = 1.81,P <0.001),但在多变量分析中未发现这种关联。特定手术会明显增加 HAI 风险:临时气管切开术(AOR = 22.69,P <0.001)、中心静脉压力监测(AOR = 6.74,P <0.001)、延长有创机械通气(AOR = 4.44,P <0.001)和静脉导管插入术(AOR = 1.58,P <0.05)。在多变量分析中,综合高风险手术发生 HAI 的可能性更高(OR = 2.51,P <0.001)。高风险科室也与 HAI 明显相关(OR = 6.13,P <0.001)。结论这项研究表明,特定的侵入性手术(如临时气管切开术)会显著增加 HAI 风险。研究结果强调了有针对性的感染预防和控制程序的必要性,并支持在制定应对 HAI 的政策时采用记录关联等创新方法的必要性。这些发现为临床实践和医疗保健政策提供了参考,以提高患者安全和护理质量。
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引用次数: 0
Evaluation of the antimicrobial effect of a far-uv radiation lamp in a real-life environment 评估远紫外辐射灯在真实环境中的抗菌效果
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-08-18 DOI: 10.1016/j.infpip.2024.100390
Szava Bansaghi , Jörn Klein

Background

Using far-Ultraviolet-C (UVC) radiation with an emission maximum of 222 nm, has the potential to kill bacteria while not being harmful to humans and can be used continuously in public areas. Elevators pose a high risk of infection transmission, as they are small, crowded spaces with poor ventilation. In such a setting continuous decontamination would be very useful. This study aimed to measure the effectiveness of a far-UVC lamp installed in a frequently used elevator by comparing the bacterial load found in that elevator with the bacterial load in a control elevator.

Methods

Microbial load was measured by different methods; ATP bioluminescence, surface samples were collected by contact slides, contact plates, and swabbing. Air samples were also collected.

Results

No significant differences were found in the microbial content between the control elevator and the UV-lamp elevator, regardless of whether the UV-lamp was always on, or was used with a motion sensor to turn off when someone entered the elevator.

Conclusions

The results suggest that the far-UVC requires a longer time to kill the bacteria, while the people traffic were continuously re-contaminating the elevators.

背景使用最大发射波长为 222 纳米的远紫外线-C(UVC)辐射有可能杀死细菌,同时对人体无害,而且可以在公共场所持续使用。电梯空间狭小、拥挤、通风不良,因此感染传播的风险很高。在这样的环境中,持续净化将非常有用。本研究旨在通过比较电梯中发现的细菌量和对照电梯中的细菌量,来衡量安装在常用电梯中的远紫外灯的效果。结果无论紫外线灯是一直开着,还是使用运动传感器在有人进入电梯时关闭,对照电梯和紫外线灯电梯中的微生物含量都没有发现明显差异。
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引用次数: 0
Airborne SARS-CoV-2 RNA detected during deliveries with unmasked patients 在接生未戴口罩病人时检测到空气传播的 SARS-CoV-2 RNA
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-08-17 DOI: 10.1016/j.infpip.2024.100389
Sara Thuresson , Malin Alsved , Åsa Leijonhufvud , Andreas Herbst , Patrik Medstrand , Jakob Löndahl , Carl-Johan Fraenkel

Background

Healthcare workers in obstetric clinics may be exposed to airborne SARS-CoV-2 when treating patients with COVID-19.

Method

In this study, performed during the midst of the pandemic, air samples were collected in delivery rooms during childbirth and analysed for SARS-CoV-2 RNA content.

Result

Six of 28 samples collected inside delivery rooms were positive for SARS-CoV-2, but none in anterooms or corridors. Five of the six positive samples were from the same occasion.

Discussion

This indicates that some patients could be major sources of exhaled virus, although the individual variation is large, and it is thus difficult to predict the risk of infection.

背景产科诊所的医护人员在治疗 COVID-19 患者时可能会接触到空气中传播的 SARS-CoV-2 病毒。方法在大流行期间进行的这项研究中,收集了分娩时产房内的空气样本,并对其进行了 SARS-CoV-2 RNA 含量分析。讨论这表明一些病人可能是呼出病毒的主要来源,尽管个体差异很大,因此很难预测感染的风险。
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引用次数: 0
Hospital-acquired respiratory viral infections while applying droplet precautions on-site (DroPS) - prospective observation during the 2019/20 influenza season, Bern, Switzerland 现场采用飞沫预防措施(DroPS)时医院获得性呼吸道病毒感染--2019/20流感季节前瞻性观察,瑞士伯尔尼
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-07-26 DOI: 10.1016/j.infpip.2024.100386
Michèle Birrer , Katrien Draps , Fabienne Hobi , Marianne Laguardia , Eveline Hofmann , Martin Luginbühl , Martin Perrig , Drahomir Aujesky , Jonas Marschall , Rami Sommerstein

Single room isolation for respiratory viral infections (RVI), like influenza, puts hospitals under pressure. During the influenza season 2019/20, we implemented Droplet precautions on-site (DroPS) for RVI in two acute care hospitals and prospectively assessed the rate of hospital-acquired RVI (HARVI). 318 patients were admitted with RVI, 85 had Influenza or RSV, 75 stayed in multi-bed rooms with DroPS. From 764 patients at risk, hospitalised ≥ three days in a multi-bed room, 11 (1.4%) developed a clinical HARVI, and three tested positive (3/764, 0.4%; 2x RSV, 1x influenza). DroPS may represent an alternative strategy to deal with respiratory viral infections.

呼吸道病毒感染(RVI)(如流感)的单间隔离给医院带来了压力。在2019/20流感季节,我们在两家急症医院针对RVI实施了现场飞沫预防措施(DroPS),并对医院获得性RVI(HARVI)的发生率进行了前瞻性评估。318 名患者因 RVI 入院,其中 85 人患有流感或 RSV,75 人住在采用 DroPS 的多床位病房。在 764 名住院时间≥ 3 天的高危患者中,11 人(1.4%)出现了临床 HARVI,3 人检测呈阳性(3/764,0.4%;2 人感染 RSV,1 人感染流感)。DroPS 可能是应对呼吸道病毒感染的另一种策略。
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引用次数: 0
Infection prevention and control factors associated with post-cataract surgery endophthalmitis - a review of the literature from 2010 – 2023 与白内障手术后眼内炎相关的感染预防和控制因素 - 2010 - 2023 年文献综述。
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-07-26 DOI: 10.1016/j.infpip.2024.100387
O.A. Saba, Y. Benylles, M.H. Howe, T. Inkster, E.L. Hooker

Patients undergoing cataract surgery are at risk of post-cataract surgery endophthalmitis (PCSE), a sight-threatening complication. Cataract surgery is a relatively straightforward and quick procedure often performed under local anaesthetic. It is therefore simple to scale up to reduce the currently long waiting times, but it is important to maintain patient safety when considering high throughput surgery. This literature review aimed to identify appropriate infection prevention and control (IPC) measures to support increased throughput of cataract surgery in Scotland. Database searches were conducted using Medline and Embase from 2010 to 2023. Further hand-searching was also performed. The organisms associated with PCSE and IPC factors relevant to PCSE were analyzed. A range of microorganisms was associated with PCSE, where outbreak reports were most associated with Gram-negative bacteria and fungi, whereas retrospective chart reviews were most associated with Gram-positive bacteria. IPC risk factors identified were related to the built environment and issues with sterilization. Specifically, the sources of outbreaks included failures in the ventilation system, as well as contaminated ophthalmic solutions, surgical instruments, and medications. The factors identified in this review should be considered when implementing high throughput cataract surgery to ensure that patient safety is maintained.

接受白内障手术的患者有可能患上白内障手术后眼内炎(PCSE),这是一种威胁视力的并发症。白内障手术是一种相对简单快捷的手术,通常在局部麻醉下进行。因此很容易扩大手术规模,缩短目前较长的等待时间,但在考虑高通量手术时,维护患者安全非常重要。本文献综述旨在确定适当的感染预防和控制 (IPC) 措施,以支持提高苏格兰白内障手术的吞吐量。我们使用 Medline 和 Embase 对 2010 年至 2023 年的数据库进行了检索。此外还进行了进一步的人工搜索。分析了与 PCSE 相关的微生物以及与 PCSE 相关的 IPC 因素。与 PCSE 相关的微生物种类繁多,其中与革兰氏阴性菌和真菌相关的疫情报告最多,而与革兰氏阳性菌相关的回顾性病历评论最多。已确定的 IPC 风险因素与建筑环境和消毒问题有关。具体来说,爆发源包括通风系统故障以及受污染的眼科溶液、手术器械和药物。在实施高通量白内障手术时,应考虑本研究中发现的因素,以确保患者安全。
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引用次数: 0
Diagnostic stewardship: establishing the role of the hospital nurse to inform local engagement strategies 诊断管理:确立医院护士的作用,为地方参与战略提供信息
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-07-24 DOI: 10.1016/j.infpip.2024.100381
Sue Bowler , Jo Brown

Background

Diagnostic stewardship is ‘coordinated guidance and interventions to improve appropriate use of microbiological diagnostics to guide therapeutic decisions’ and a fundamental part of antimicrobial stewardship and the nursing role. The role of the nurse in diagnostic stewardship is relatively unknown and an underused resource. Lack of involvement and training in diagnostic stewardship can lead to inaction or incorrect actions, either of which may be detrimental to patient management, outcomes and care.

Aim

To determine the role of the hospital adult nurse in diagnostic stewardship to inform local engagement strategies.

Methods

The methodology was informed by Whiffin's (2020) systematic search approach. Electronic databases were searched from 2016 to 2022. The studies included were primary research papers involving adult nurses working in a hospital setting, with findings relevant to a diagnostic stewardship role. Thematic analysis was chosen to understand and compare the results, findings and recommendations of the studies.

Findings

Seven studies were included in the review. The identified themes were: (i) nursing role – to recognize infection, aid diagnosis and review results; (ii) nurse challenges – lack of knowledge and confidence to implement diagnostic stewardship; and (iii) Nurse education, empowerment and use of clinical tools.

Conclusion

Research studies do not consistently recognize the full scope of the diagnostic stewardship nursing role, signifying that nurses remain an underused resource in promoting diagnostic stewardship. Research-based clarification of the role of the nurse in diagnostic stewardship, outlined in this review, is therefore vital. Further UK-based, nurse-led research is needed to capture the impact of nurse-driven diagnostic stewardship interventions.

背景诊断监管是 "协调指导和干预措施,以改善微生物诊断的合理使用,从而指导治疗决策",是抗菌药物监管和护理工作的基本组成部分。护士在诊断管理中的作用相对不为人知,是一种未得到充分利用的资源。缺乏诊断监管方面的参与和培训可能会导致不作为或不正确的行为,而这两种情况都可能会对患者管理、治疗效果和护理造成不利影响。检索了 2016 年至 2022 年的电子数据库。所纳入的研究均为主要研究论文,涉及在医院环境中工作的成人护士,研究结果与诊断监管角色相关。选择了主题分析法来了解和比较研究的结果、发现和建议。确定的主题有(i)护士的角色--识别感染、协助诊断和审查结果;(ii)护士面临的挑战--缺乏实施诊断管理的知识和信心;以及(iii)护士教育、授权和临床工具的使用。因此,本综述对护士在诊断指导中的作用进行了基于研究的澄清,这一点至关重要。英国需要进一步开展以护士为主导的研究,以了解护士驱动的诊断监管干预措施的影响。
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引用次数: 0
How did the COVID-19 pandemic affect antibiotic consumption within humanitarian emergencies? Results from five humanitarian contexts COVID-19 大流行如何影响人道主义紧急情况下的抗生素消费?五种人道主义情况下的结果。
IF 1.8 Q3 INFECTIOUS DISEASES Pub Date : 2024-07-18 DOI: 10.1016/j.infpip.2024.100385
Tuba Yavuz , Kate Clezy , Kristina Skender , Jacob Goldberg , Frédérique Vallières

Introduction

Both high- and low-income countries reported increased antibiotic consumption among COVID-19 patients during the first months of the pandemic. To date, however, no studies have examined changes in antibiotic consumption during the COVID-19 pandemic within humanitarian emergency contexts.

Method

Data was collected by Médecins Sans Frontières (MSF) for the years 2018–2021 across the following humanitarian settings: Afghanistan (Lashkar Gah), Bangladesh (Kutupalong), the Democratic Republic of Congo (Mweso and Baraka), and South Sudan (Bentiu). Inpatient and outpatient antibiotic consumption was calculated as Daily Defined Dose (DDD) per 1000 inhabitants per day, as per the World Health Organisation's (WHO) Collaborating Centre for Drug Statistics Methodology. Interrupted time series (ITS) analysis, using an autoregressive integrated moving average (ARIMA) model was used to analyse retrospective monthly antibiotic consumption. The impact of COVID-19 pandemic was evaluated as total antibiotic consumption and according to WHO Access, Watch, Reserve (AWaRe) group classifications within each humanitarian setting.

Results

The COVID-19 pandemic had no statistically significant impact on total antibiotic consumption in South Sudan (Bentiu) and Bangladesh (Kutupalong). Similarly, the pandemic had no impact on total antibiotic consumption in DR Congo (Baraka), despite an initial 0.27% (estimate=.274, p-value=0.006) increase in March 2020 driven by Access group antibiotics. Meanwhile, total antibiotic consumption in DR Congo (Mweso) and Afghanistan (Lashkar Gah) declined by 0.74% (estimate = −.744, p = 0.003) and 0.26% (estimate = −.26, p < 0.001), respectively with the COVID-19 pandemic.

Conclusion

Further studies are required to investigate what may have contributed to these results.

导言在COVID-19大流行的最初几个月中,高收入国家和低收入国家都报告称COVID-19患者的抗生素消耗量有所增加。无国界医生组织(MSF)收集了2018-2021年在以下人道主义环境中的数据:阿富汗(拉什卡尔加)、孟加拉国(库图帕隆)、印度(拉什卡尔加):阿富汗(拉什卡尔加)、孟加拉国(库图帕隆)、刚果民主共和国(姆韦索和巴拉卡)和南苏丹(本提乌)。根据世界卫生组织(WHO)药物统计合作中心的方法,住院病人和门诊病人的抗生素消耗量按每千人每日定义剂量(DDD)计算。采用自回归综合移动平均(ARIMA)模型进行间断时间序列(ITS)分析,对每月抗生素消耗量进行回顾性分析。结果COVID-19大流行对南苏丹(本提乌)和孟加拉国(库图帕隆)的抗生素总消耗量没有显著的统计学影响。同样,大流行对刚果民主共和国(巴拉卡)的抗生素总消费量也没有影响,尽管在 2020 年 3 月,在获取组抗生素的推动下,抗生素总消费量最初增加了 0.27%(估计值=0.274,P 值=0.006)。同时,刚果(金)和阿富汗(拉什卡尔加)的抗生素总消费量在 COVID-19 大流行时分别下降了 0.74%(估计值=-.744,P=0.003)和 0.26%(估计值=-.26,P< 0.001)。
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Infection Prevention in Practice
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