日本新冠肺炎大流行期间血液透析患者感染预防措施:2022年全国问卷随访调查

IF 0.9 Q4 UROLOGY & NEPHROLOGY Renal Replacement Therapy Pub Date : 2023-10-20 DOI:10.1186/s41100-023-00509-9
Toyohiro Hashiba, Yuka Suagawara, Masao Iwagami, Tomoyuki Yamakawa, Munekazu Ryuzaki, Kan Kikuchi, Takashi Kadowaki, Masaomi Nangaku
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The survey investigated (i) the characteristics of the facilities, (ii) infection prevention measures in routine dialysis practice, (iii) experience in treating COVID-19-positive/suspected dialysis patients, (iv) feasibility of various isolation measures, (v) nosocomial transmission, (vi) COVID-19 vaccination status, and (vii) impact on medical practice and economic aspects. We then compared the answers from the previous survey conducted in 2020 with those of the current survey. Results Responses were obtained from 1956 facilities (response rate: 46.6%). Overall, 83.5% of the facilities have examined and treated patients with COVID-19. While the compliance rate improved since the previous survey, it remained low for some factors such as linen exchange. More than 60% of the facilities reported that they were coping with a lack of manpower and space for isolation. Most patients at the surveyed facilities were vaccinated for COVID-19; only 2.8% were unvaccinated. 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引用次数: 0

摘要

背景2023年新型冠状病毒病(COVID-19)将继续流行,采取感染控制措施在医疗实践中仍具有重要意义。2020年,我们对日本2019冠状病毒病疫情下血液透析患者感染预防措施实施情况进行了问卷调查。自那时以来,已启动了COVID-19疫苗接种,并发生了新变种的爆发。透析设施的感染预防措施可能已经改变;因此,我们进行了后续调查。方法在2022年10月11日至11月14日期间,我们向日本的4198家透析机构分发了问卷调查。该调查调查了(i)设施的特点,(ii)常规透析实践中的感染预防措施,(iii)治疗COVID-19阳性/疑似透析患者的经验,(iv)各种隔离措施的可行性,(v)院内传播,(vi) COVID-19疫苗接种情况,以及(vii)对医疗实践和经济方面的影响。然后,我们将2020年进行的上一次调查的答案与本次调查的答案进行了比较。结果共获得回复1956家,回复率46.6%。总体而言,83.5%的设施对COVID-19患者进行了检查和治疗。虽然自上次调查以来,合规率有所提高,但由于亚麻交换等因素,合规率仍然很低。超过60%的设施报告说,他们正在应对缺乏人力和隔离空间的问题。被调查机构的大多数患者都接种了COVID-19疫苗;只有2.8%的人没有接种疫苗。与未接种疫苗的患者相比,接种疫苗的患者感染率较低(接种疫苗的9.2% vs未接种疫苗的41.2%;原油风险比[RR] 0.22;95%置信区间[CI] 0.22-0.23;p & lt;0.001)和死亡率(接种疫苗0.3%对未接种疫苗6.6%;粗RR 0.05;95% ci 0.04-0.06;p & lt;0.001)。结论大部分感染预防措施的实施率较前一次调查有所提高。然而,劳动力短缺、空间不足以及与其他医疗设施的协调问题仍然是一个挑战。COVID-19疫苗接种与日本血液透析患者感染和死亡率降低显著相关,这需要进一步的混杂校正研究来证实。
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Infection prevention measures for patients on hemodialysis during COVID-19 pandemic in Japan: a nationwide questionnaire follow-up survey in 2022
Abstract Background Coronavirus disease (COVID-19) continues to be prevalent in 2023, and infection control measures against it remain important in medical practice. In 2020, we conducted a questionnaire survey mainly on the implementation of infection prevention measures for patients on hemodialysis under COVID-19 pandemic in Japan. Since then, vaccination for COVID-19 has been initiated and the outbreak of new variants had occurred. Infection prevention measures at dialysis facilities have possibly changed; therefore, we conducted a follow-up survey. Methods Between October 11 and November 14, 2022, we distributed a questionnaire survey to 4,198 dialysis facilities in Japan. The survey investigated (i) the characteristics of the facilities, (ii) infection prevention measures in routine dialysis practice, (iii) experience in treating COVID-19-positive/suspected dialysis patients, (iv) feasibility of various isolation measures, (v) nosocomial transmission, (vi) COVID-19 vaccination status, and (vii) impact on medical practice and economic aspects. We then compared the answers from the previous survey conducted in 2020 with those of the current survey. Results Responses were obtained from 1956 facilities (response rate: 46.6%). Overall, 83.5% of the facilities have examined and treated patients with COVID-19. While the compliance rate improved since the previous survey, it remained low for some factors such as linen exchange. More than 60% of the facilities reported that they were coping with a lack of manpower and space for isolation. Most patients at the surveyed facilities were vaccinated for COVID-19; only 2.8% were unvaccinated. Compared with unvaccinated patients, vaccinated patients had a lower infection rate (vaccinated 9.2% vs. unvaccinated 41.2%; crude risk ratio [RR] 0.22; 95% confidence interval [CI] 0.22–0.23; p < 0.001) and mortality rates (vaccinated 0.3% vs. unvaccinated 6.6%; crude RR 0.05; 95% CI 0.04–0.06; p < 0.001). Conclusion The implementation rates of most of the infection prevention measures improved compared to those in the previous survey. However, labor shortages, lack of space, and problems coordinating with other medical facilities remain a challenge. COVID-19 vaccination was significantly associated with reduced infection and mortality in Japanese patients on hemodialysis, which should be confirmed by further studies with confounding adjustment.
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来源期刊
Renal Replacement Therapy
Renal Replacement Therapy Medicine-Transplantation
CiteScore
1.70
自引率
8.30%
发文量
57
审稿时长
19 weeks
期刊最新文献
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