Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Các Biện Pháp Kiểm Soát Nhiễm Trùng Để Ngăn Ngừa Các Bệnh Nấm Xâm Lấn Ở Người Nhận Ghép Tế Bào Gốc Huyết Học
Tóm tắt
Các bệnh nấm xâm lấn, đặc biệt là bệnh aspergillosis, là nguyên nhân quan trọng gây tình trạng bệnh tật và tử vong ở những người nhận ghép tế bào gốc đồng loại. Bào tử nấm có mặt khắp nơi trong môi trường. Các hướng dẫn do Trung tâm Kiểm soát và Phòng ngừa Dịch bệnh (CDC) và các tổ chức có thẩm quyền khác thiết lập, tập trung vào các phương pháp nhằm giảm tiếp xúc với bào tử nấm. Những khuyến nghị này bao gồm việc tránh các khu vực và hoạt động dự kiến sẽ dẫn đến mức độ cao của bào tử nấm (ví dụ: xây dựng, làm vườn) và sử dụng các đơn vị được thiết kế đặc biệt (môi trường bảo vệ) nơi có những tiêu chuẩn bổ sung (ví dụ: phòng lọc HEPA) được áp dụng để giảm thiểu tiếp xúc với nấm. Những khuyến nghị này dựa trên các tiêu chí đồng thuận và dữ liệu lâm sàng hạn chế hầu hết xuất phát từ các nghiên cứu hồi cứu tại trung tâm đơn lẻ. Thêm vào đó, những người nhận ghép tế bào gốc có hệ miễn dịch suy giảm nghiêm trọng thường được quản lý như bệnh nhân ngoại trú, nơi mà tiêu chuẩn kỹ thuật của môi trường bảo vệ cho bệnh nhân nội trú là không khả thi. Trong sự vắng mặt của một đợt bùng phát với nguồn gốc môi trường xác định (ví dụ: một ống thông gió bị ô nhiễm), không thể phân biệt đáng tin cậy giữa bệnh aspergillosis lây nhiễm cộng đồng và bệnh nosocomial. Việc tuân thủ các hướng dẫn kiểm soát nhiễm trùng, công nhận những hạn chế của chúng, kết hợp với việc sử dụng dự phòng kháng nấm theo bằng chứng cho những người nhận ghép có nguy cơ cao nhất, được cho là sẽ là phương pháp hiệu quả nhất để ngăn ngừa các bệnh nấm xâm lấn.
Từ khóa
#bệnh nấm xâm lấn #bệnh aspergillosis #tế bào gốc huyết học #kiểm soát nhiễm trùng #kháng nấmTài liệu tham khảo
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