针对无症状携带产碳青霉烯酶肠杆菌的初级卫生保健患者,开发机构间信息传递实践模型。

Medycyna pracy Pub Date : 2023-11-14 Epub Date: 2023-09-12 DOI:10.13075/mp.5893.01393
Małgorzata Timler, Wojciech Timler, Remigiusz Kozłowski, Agnieszka Zdęba-Mozoła, Michał Marczak, Dariusz Timler
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引用次数: 0

摘要

背景:耐药细菌是世界范围内死亡的主要原因之一。这些细菌中的一个重要群体是产生碳青霉烯酶的肠杆菌科(CPE)。本研究的目的是建立一种针对无症状CPE携带者的诊断和治疗模型。材料和方法:来自与医疗保健相关的不同部门的专家团队,根据先前研究收集的数据讨论主题。工作会议分散在2022年6月至12月之间。通过反复讨论和文献检索,我们达成了共识。结果:检测到CPE的机构需要创建病原体警报说明,并通知卫生流行病学站和国家微生物抗微生物药物敏感性参考中心——这些机构和患者都不需要通知初级保健医生。在初级保健诊所,有可能通过教育患有CPE的患者和与其接触的人来努力打破CPE的传播,并采取行动寻找具有CPE定植危险因素的患者。为了改善卫生保健系统各个层次之间的沟通,可以在CPE病例的出院记录中引入标准化信息,这些信息将以电子方式传输到初级保健机构。它可以作为患者知识和教育的来源,并通过检查患者的风险因素,从而提高CPE定植测试的性能,从而有助于有效地防治CPE的传播。结论:已建立的良好做法模式需要改变法律法规及其实施,这将减少CPE在卫生保健设施中的传播,并将使其未来得到改善。中华医学杂志,2009;33(4):563 - 567。
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Developing a model of information transfer practice between institutions targeted at primary health care patients who are asymptomatic carriers of carbapenemase producing Enterobacteriacae.

Background: Drug-resistant bacteria are one of the main reasons of deaths worldwide. A significant group of these bacteria are carbapenemase producing Enterobacteriaceae (CPE). The goal of this study was to develop a diagnostic and therapeutic model targeted at asymptomatic carriers of CPE.

Material and methods: A team of experts from different branches connected to health care, discussing the topic based on the data collected from previous research. Working sessions were dispersed between June and December 2022. The consensus has been reached via repeated discussion and literature search.

Results: The facility where CPE are detected is required to create an alert pathogen note and to notify sanitary-epidemiological station and National Reference Centre for Antimicrobial Susceptibility of Microorganisms - neither these institutions, nor the patient are required to notify the primary care physician. In primary care clinics, it is possible to work towards breaking the transmission of CPE by educating patients with CPE and persons who were in contact with them, and to undertake actions in order to look for patients with risk factors for CPE colonisation. In order to improve communication between individual levels of the health care system, standardised information could be introduced to the discharge note about a case of CPE, which will be electronically transmitted to the primary care facility. It might contribute to effective combating of the spread of CPE, by serving as a source of knowledge and education for patients and by checking the patient's risk factors, which will improve the performance of tests for CPE colonisation.

Conclusions: The established model of good practice requires a change of legal regulations and its implementation, which will reduce the spread of CPE in health care facilities and will enable its future improvement. Med Pr Work Health Saf. 2023;74(4):263-70.

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