世界卫生组织医疗机构耐碳青霉烯的肠杆菌科细菌铜绿假

11,21.6100412.61004120062009SCI802017InterpretationofGuidelinesforthePreventionandControlofCarbapenem-resistantEnterobacteriaceae,AcinetobacterbaumanniiandPseudomonasaeruginosainhealthcarefacilitiesQIAOFu1,ZONGZhiyong1,21.InfectionPreventionandControlDepartment,WestChinaHospital,SichuanUniversity,Chengdu,Sichuan610041,P.R.China2.DepartmentofInfectiousDiseases,WestChinaHospital,SichuanUniversity,Chengdu,Sichuan610041,P.R.ChinaCorrespondingauthor:ZONGZhiyong,Email:[e-mail]wideconsensusthaturgentactionisneededtopreventandcontrolmulti-drugresistantorganismsinhealthcaresettings,especiallyCarbapenem-resistantEnterobacteriaceae(CRE),Carbapenem-resistantAcinetobacterbaumannii(CRAB)andCarbapenem-resistantPseudomonasaeruginosa(CRPsA).In2017,tofocusonthistopic,worldhealthorganizationorganizedexpertsworldwidetodevelopguidelinesforthepreventionandcontrolofCRE,CRPsAandCRAB.Inthispaper,weintroducedthebackground,developmentprocess,mainmeasures,advantagesanddisadvantagesoftheguidelinestohelpinfectionpreventionandcontrolpractitionerstakeactionsproperlybasedontheguidelines.KeywordsCarbapenem-resistantEnterobacteriaceae;Carbapenem-resistantAcinetobacterbaumannii;Carbapenem-resistantPseudomonasaeruginosa;WorldHealthOrganization;GuidelinesDOI10.7507/[e-mail]20183333?1?1Carbapenem-resistantEnterobacteriaceaeCRECarbapenem-resistantAcinetobacterbaumanniiCRABCarbapenem-resistantPseudomonasaeruginosaCRPsA49.5%19.2%7.9%WorldHealthOrganizationWHO2014Carbapenem-resistantKlebsiellapneumoniaeCRKP50%CRKP2014JAMA39CRE[1]MetaCRE26%44%CRPsA3CRAB[2]WHO[3]2WHODepartmentofServiceDeliveryandSafetyWHO20146PICOPopulation/ParticipantsInterventionComparatorOutcomeInfectionPreventionandControlIPCGRADE3CRAB-CRE-CRPsA83.1IPC2016WHO[4]CRE-CRAB-CRPsA3.2WHO2005WHO2009[5]CRE-CRAB-CRPsAWHO[6]CRE-CRAB-CRPsAWHO3.3CRE-CRAB-CRPsA?2?WestChinaMedicalJournal,Mar.2018,Vol.33,No.3CRE-CRAB-CRPsACRE-CRAB-CRPsACRE4CRECRECRE111CRECRECRECRABCRPsACRE-CRAB-CRPsACRE-CRAB-CRPsA3.4CRE-CRAB-CRPsACRE-CRAB-CRPsA3.5CRE-CRAB-CRPsACRE-CRAB-CRPsA3.6CRE-CRAB-CRPsA31000ppm[7]3d51.5h165CRE-CRAB-CRPsA3.7CRE-CRAB-CRPsACRE-CRAB-CRPsACRABCRPsACRE-CRAB-CRPsA3.8420183333?3?20152015[8]CRE-CRAB-CRPsA5CRE-CRAB-CRPsACHINET201615.4%28.7%65.3%[9]20145.55%29.96%[10]CRE-CRAB-CRPsACRE-CRAB-CRPsA/[11]6WHOEpsteinL,HunterJC,ArwadyMA,etal.NewDelhimetallo-lactamase-producingcarbapenem-resistantEscherichiacoliassociatedwithexposuretoduodenoscopes.JAMA,2014,312(14):1447-1455.1FalagasME,TansarliGS,KarageorgopoulosDE,etal.Deathsattributabletocarbapenem-resistantEnterobacteriaceaeinfections.EmergInfectDis,2014,20(7):1170-1175.2WorldHealthOrganization.Guidelinesforthepreventionandcontrolofcarbapenem-resistantEnterobacteriaceae,AcinetobacterbaumanniiandPseudomonasaeruginosainhealthcarefacilities.(2017-11)[2018-03-01].(2016-11)[2018-03-01].:firstglobalpatientsafetychallengecleancareissafer5?4?WestChinaMedicalJournal,Mar.2018,Vol.33,No.3care.(2009)[2018-03-01].=AFABBB9D049859F724DC35B633A39A08?doi=10.1.1.170.7842&reprep1&typepdf.WorldHealthOrganization.Evidenceofhandhygienetoreducetransmissionandinfectionsbymulti-drugresistantorganismsinhealth-caresettings.(2014)[2018-03-01].=1&ua1.6KramerA,SchwebkeI,KampfG.Howlongdonosocomialpathogenspersistoninanimatesurfaces?Asystematicreview.BMCInfectDis,2006,6:130.7,,,..,2015,14(1):1-9.8,,,.2016CHINET9.,2017,17(5):481-491.,,,.2014.,2016,35(3):9-12.10StewardsonAJ,SaxH,Gayet-AgeronA,etal.Enhancedperformancefeedbackandpatientparticipationtoimprovehandhygienecomplianceofhealth-careworkersinthesettingofestablishedmultimodalpromotion:asingle-centre,clusterrandomisedcontrolledtrial.LancetInfectDis,2016,16(12):1345-1355.112018-03-022018-03-0620183333?5?