best of infection control: 2015 eccmid

7/21/2019 Best of Infection Control: 2015 ECCMID

1/56

!"# %&'&()&*#)+

!"# %#&' () *)+#,-.) /.)0'.5? ,-./0 5-!0

?8(2 ?71#&(& 3 .4'1#)8" .#9& =(:&)6>(;


2/56

Hlkafihts la Iktgrgst Xtetgngkt

! @(8()#8" )>(E#)9;

! .&)6>( !2#9>' :>' O4#2&"#(&;0 %>;#6>( %8H&';0

8(2 =(*#9&2 -&*#&B; G =A?!


3/56

!"(8 0&52 7(55 '#1(#7 0"# 3495(8"#= 5(0#'&04'#

8(),# 0"# :6>;


4/56

H#5#,-.) ,'(0#'(& 7#'# ).)F8I80#N&-, K(L#L &'9(0'&'IP

&)= * =(=)U0 ()0#)-.)&55I (C).'# I.4' 804=I


5/56

Xtepdyflhlhhus eurgus ekb N_XE


6/56

O#&88#88 7"#0"#' C.7)8_C5.1#8_(8.5&-.)_,.".'-)C

&== &)I0"()C 0. "&)= "IC(#)# &)= =#,.5.)(8&-.)

! @OHB (8 =#,5()()CG .0"#' 3&0".C#)8 (),'#&8()C

! E#83(0# N&)I 0'(&58G N.80 #X#,-1# 80'&0#CI 4),#'0&()

! D&)= "IC(#)#G 8,'##)()CG =#,.5.)(R&-.)G ,.)0&,0 (8.5&-.)

! H(=#F#X#,08 .+ (8.5&-.)

! J#7#' 1(8(08G =#3'#88(.)_&)W(#0I

Fekhgt ?057: 847=5521-29 (Qigwplikt)


7/56

Q*/S? /&'#+45 &T#)-.) 0. "&)=5()C .+ #W,'#N#)0 ()

)#79.') 9&9(#8 .' ()+&)08

E_IH ?052, 8=52

! !7. Q*/S8 () Y&3&) K:6>]PG &1#'&C# &C# :6 =&I8

! Q&8&5 &)= +#,&5 ,4504'#

! @45-35#W Z/OG @VH!G H//N#,G 83&F0I3#8G ; #W.0.W() C#)#8! >^ [ )&8&5 8,'##) 3.8(-1# K:\_>\`P

! :> 3&-#)08 (),54=#=


8/56

Q*/S? /&'#+45 &T#)-.) 0. "&)=5()C .+ #W,'#N#)0 ()

)#79.') 9&9(#8 .' ()+&)08

E_IH ?052, 8=52

! @4-35#W Z/O

! >e .+ :> F H&N# () +#,#8_)&8&5G ] .+ :> o H&N# =.N()&)0 ,5.)#

!

H//*'+0I3#8G (,$F0I3#8 &)= #W.0.W() '#3#'0.('# o :>_:>! Dlspitef 5= 8 hflkgs - HH7-XHHngh IIe, HH4-XHHngh IQf ekb HH4-

XHHngh IQo

! Dlspitef ?= 5 hflkg - HH5-XHHngh IQe


9/56

Q*/S? /4''#)0 @OHB 3'#1#)-.) 80'&0#C(#8 5(2#

8,'##)()C &)= =#,.5.)(R&-.) =.)U0 7.'2

IHDG ?052 (Eprif)= 87(2)

! B(N?


10/56

Q*/S? /4''#)0 @OHB 3'#1#)-.) 80'&0#C(#8 5(2#

8,'##)()C &)= =#,.5.)(R&-.) =.)U0 7.'2

IHDG ?052 (Eprif)= 87(2)


11/56

H,'##)()C &)= E#,.5.)(R&-.) E.#8)U0 c.'2 () Q*/S

IHDG ?052 (Eprif)= 87(2)

!

32 (?.0%) wgrg N_XE+ (nuftipfg PACG)

! 59 tltef bgvgflpgb ikaghtilk (?1%)

! 2?% (4) ikaghtgb ogalrg shrggkikc

!

42% (1?/32) ehquirgb N_XE ik KIHW

! Lkfy 51% bgtghtgb lk ebnissilk

! 8.7% la DHS (3/?02) N_XE+

!

Hlkhfusilk= Bghlflkizetilk klt gklucd


12/56

H,'##)()C &)= E#,.5.)(R&-.) =.#8)U0 7.'2 () )4'8()C

".N#8 #(0"#'d

IHDG (?057): 81(2)=205-4

! /5480#'FO/! () H7(0R#'5&)=

! >6; Q4'8()C D.N#8 K^] ()0#'1#)-.)G ^> ,.)0'.5P

! /.)8#)0ddd

! B55 H,'##)#=? )&8&5G C'.()G 45,#'G 4'()# ,4504'#


13/56

!"#I 7.'2#= "&'= &)= "&= & 9(C 94)=5#

IHDG (?057): 81(2)=205-4

!

Oukbfg=

! 7 beys la kesef nupirlhik

! 7 beys la HDC lref riksg twihg pgr bey

! 7 beys la HDC sdlwgrs ikhfubikc HDC sdenpll lk

bey 5 ekb 7.

! Gkvirlkngktef bisikaghtilk ikhfubgb beify hfltdikc

hdekcgs alr 7 beys, kgw fikgks lk bey 5 ekb bey 7,

ekb beify ogb/teofg/pdlkg/rgnltg/wdggfhdeir/wefjgr bisikaghtilk witd 30% efhldlf

! !!!!!!!!!!!!!!!!!!!


14/56

g40 ).0 N&T#' ".7 0"#I 85(,#= 0"#(' =&0&G

8,'##)()C_=#,.5.)(R&-.) =(=)U0 7.'2

IHDG (?057): 81(2)=205-4


15/56

g40 ).0 N&T#' ".7 0"#I 85(,#= 0"#(' =&0&G

8,'##)()C_=#,.5.)(R&-.) =(=)U0 7.'2

IHDG (?057): 81(2)=205-4


16/56

@EOi g4)=5# () Q4'8()C D.N#8? B /5480#'F

'&)=.N(R#= !'(&5

MENE Iktgrk Ngb. bli=50.5005/meneiktgrkngb.?057.58?

! /5480#'FO/!G >: )4'8()C ".N#8 K\ ()0#'1#)-.)G \ ,.)0'.5P

!


17/56

g'.&= .40,.N#8 #1&54&0#= 940 9'.&= 9#)#m08

).0 8##) 7(0" 94)=5#

! %'#C8'7 >49)>C&D I>*&'8"" ,M-J H'&*8"&()& 2&(;#97 '89&0

2&@(&2 8; &8)+ H8'6)#H8(9F; 9>98" (4CN&' >: ,M-JKH>;#6*&

8(89>C#) ;#9&; 8)'>;; 8"" ,M-J; H&' *#;#9 8*&'81&2 >*&' 9+&

24'86>( >: +#; >' +&' H8'6)#H86>(LI

! P+#; B>4"2 '&;4"9 #( '&;#2&(9; IB#9+ H&';#;9&(9 ,M-J )>">(#U86>(

_+8*#(1X 8 +#1+&' H'&*8"&()& 9+8( ;>C&>(& B#9+ #(9&'C#R&(9 >' (>

)>">(#U86>(I 8(2 '&;#2&(9; )>">(#U&2 89 C>'& ;#9&; _4H 9> ;&*&(

B&'& 9&;9&2X +8*#(1 8 +#1+&' H'&*8"&()&

!

.&)>(28'7 >49)>C&; #()"42&2 (&B ,M-J 8)W4#;#6>( 8(22&*#)&K8;;>)#89&2 ?/= N>9+ B#9+ QSSS 2&*#)&K287

2&(>C#(89>';L

MENE Iktgrk Ngb. bli=50.5005/meneiktgrkngb.?057.58?


18/56

g'.&= .40,.N#8 #1&54&0#= 940 9'.&= 9#)#m08

).0 8##) 7(0" 94)=5#

! %'#C8'7 >49)>C&

! TY] >: ;B8N; B&'& H>;#6*& _#(9&'*&(6>(


19/56

@HHB ).0 3'.0#,-1# .+ @OHB &,j4(8(-.) () &,40#F

,&'# ".83(0&5 K &0 3&-#)0 5#1#5P

IHDG (Ney ?052) 87(7)= 7?3-88

! f`f 8,'##)#= .) &=N(88(.) &)= =(8,"&'C# K@OHBM@HHBP

! :>[ @HHB .) &=N(88(.)

! e6 3&-#)08 Kf[P &,j4('#= @OHBG f:f ,.)0'.58

! Z'#=(,0.'8? &C#G 5#)C0" .+ 80&IG (),'#&8#= )4'8()C 7.'25.&=G

N&,'.5(=# #W3.84'#

! @HHB? &iO >L>e n`^[/* 6L\6F:L]6k


20/56

@HHB &33#&'8 3'.0#,-1# +'.N @OHB &0 0"# +&,(5(0I

K(L#L )4'8()C ".N#P 5#1#5

IHDG (Lhtlogr ?052) 87(50)=5?73-1?

! :\ )4'8()C ".N#8 K:66fF:6>>P

! e #W,54=#= +'.N &=N(88(.) 87&98

! >G\\> &=N(88(.) 87&98G :G>;^ 3.()0 3'#1&5#),# 87&98

! /.''#5&-.) @OHB &)= @HHB

! B=N(88(.) 3'#1&5#),#? ' l F 6L;6G 3l6L6`

! Z.()0 3'#1&5#),#


21/56

@HHB ()1#'8#5I ,.''#5&0#= 7(0" @OHB K3.()0

3'#1&5&),#P &0 0"# +&,(5(0I 5#1#5

IHDG (Lhtlogr ?052) 87(50)=5?73-1?

r > -0.13, p>0.000?)


22/56

Z'#1#)-)C @OHB &)= @HHB () &) S'9&) Y&(5 48()C /Da

IHDG (Bghgnogr ?052) 87(5?)=5211-38

! E&55&8G !#W&8 Y&(5

! ;>`\ =#0&()##8G \f =#0#)-.) =(1(8(.)8 K0&)28P

! /5480#'F'&)=.N(R#= 0&)28 ()0. 0"'## C'.438

>L /DaF8.&2#= 7&8" ,5.0"#8 &335I 0. #)-'# 9.=I @.)=&I_c#=)#8=&I_J'(=&I

:L c&0#'F8.&2#= 7&8" ,5.0"#8p 8&N# 8,"#=45#

]L Q.0"()C

! /4504'#= D&)=8_Q&'#8 o 9&8#5()#G : N.)0"8G \ N.)0"8


23/56

@OHBG @HHB '&0#8 &0 9&8#5()# &)= \ N.)0"8

!

\ @.)0"8

! @OHB K3l6L\^^P

! >6[ F ). ,5.0"

! >6L;[ 7&0#' ,5.0"

! fLe[ /Da ,5.0"

!

@HHB K3l6L6`>P

! ^>L>[ F ). ,5.0"! ;:Lf[ 7&0#' ,5.0"

! ;6Le[ /Da ,5.0"

IHDG (Bghgnogr ?052) 87(5?)=5211-38


24/56

V(1#80.,2 @OHB &N.)C 1#0#'()&'(&)8 &)= ".48#".5=

N#N9#'8 o #1(=#),# .+ 0'&)8N(88(.)

Eppf Gkvirlk Nihrloilf. ?057 Mek:45(5)=5?2-9

! Z#'"&38 ;6[ .+ @OHB 80'&()8 () 0"# Q#0"#'5&)=8 &'# VBF@OHB

! V(N(0#= =(8,'(N()&-.) .+ (,$ 0I3()C @VAB +.' VBF@OHB K@/]`f_//]`fP

! c".5# C#).N# N&33()C "&8 (N3'.1#= =(X#'#)-&-.)

! : I#&' &)&5I8(8 .+ >]^ 1#0#'()&'(&)8 &)= ".48#".5= N#N9#'8

! /4504'#= &0 9&8#5()#G :N.G \N.G >6N. >; N.

! >\ 1#0#'()&'(&)8 K7(0" >\> ,4504'#8 (),54=#=P


25/56

c".5# C#).N# N&33()C &)= VBF@OHB 0'&)8N(88(.)

&N.)C ".48#".5= N#N9#'8

! c".5# C#).N# N&38

! `f[ ()=(8-)C4(8"&95#

! >] ,5480#'8G f 8()C5#0.)8

! >6 ,5480#'8 +'.N 8()C5# 1#08

! ] ,5480#'8 7(0" 07.G 07. &)= ^ 1#08

! V(T5# 1&'(&9(5(0I &N.)C 8()C5# 1#08

! /&''(#=G '#&,j4('#= 8&N# 80'&()

! /&''(&C# =4'&-.) ;F>; N.)0"8

! >; .+ >\ ".48#".5=8 8&7

0'&)8N(88(.) .+ & 8()C5# 80'&()

! /&''(&C# =4'&-.) ;Ff N.)0"8

Eppf Gkvirlk Nihrloilf. ?057 Mek:45(5)=5?2-9


26/56

Z(C =#)8(0I )#&' ".83(0&5 3'#=(,08 VBF@OHB '(82

()=#3#)=#)0 .+ =('#,0 5(1#80.,2 #W3.84'#

PFlX Lkg. ?052 Muk ?3:9(1)=g500?92

! Z'(.'G 6L:[ 7(0".40 5(1#80.,2 #W3 o //]`fM

! >e Q#0"#'5&)=8 D.83(0&58 K:66`F:6>6P

! >6:6 )#75I @OHBM &)= \;` K\;[P @/]`f

! :e> K:e[P &'# 4)2).7) .'(C() 9I "(80.'I_0I3()C

! Z'.3.'-.) .+ 4)2).7) .'(C() &'# @/]`f

! ::[ K3(C8P 18 ^[ K). 3(C8PG OO ;L:^G 3q6L6>


27/56

Q_XE


28/56

AO


29/56

AO< &8 3'.3.'-.) .+ &55 #)0#'.,.,,&5 ()+#,-.)8

(8 (),'#&8()C5I ,&48()C DB*

M. Ektinihrlo. Hdgnltdgr. (?052) 19 (1)= 5110-5112

XXI 7?1%, P60.05

OXI ?17%, P60.05

WRI ?34%, P>0.03


30/56

*),'#&8# 8##) () 9#50 .+ +.4' +#=#'&5 80&0#8



31/56

!.0&5 AO< ,&8#8 '(8()C 0. ]L> 3#' >666 3&-#)08

() */S 8#s)C8


?4?% ikhrgesg


32/56


33/56

SHB>>66G 06>` &)= //]6 o ,.NN4)(0I 80'&()

940 ,5#&'5I "#&50",&'# &88.,(&0#=

M Hfik Nihrloilf. ?052 Ner:7?(8)=994-500?


34/56

/.NN4)(0IF80'&() .+ AOHB () Hu. Z&45.G g'&8(5

K Gkcf M Ngb. ?052 Epr 53:830(51)=57?2-85

! ]^ I. 7(0" NI,.8(8 +4)C.(=#8G =(&9#0#8G ,.,&()# 48# o

,#5545(-8G 82() ()+#,-.) o @OHB 9&,0#'#N(&

! OW 1&),.NI,() : 7##28G 0#(,.35&)() : 7##28G !!< )#C&-1#

! > 8&I 3.80 &9WG @OHB '#.,,4''#= K1&),. N(, v]:4C_N5G 0#(,.l]:P

! AOHB 7&8 H!fG H//*'+*A&G 83& 0I3# 0:`: w SHB]66

! /.)x4C&-1# 35&8N(= ,&''I()C -$.B 7&8 =(8,.1#'#=


35/56

Xurcihef Xitg Ikaghtilks


36/56

O&0#8 .+ HH* () ,.5.'#,0&5 84'C#'I &'# '#3.'0#= +.' Y&3&)

Ikaght Hlktrlf Dlsp Gpibgnilf, Qlf. 87, Kl. 1 (Mukg ?052), pp. 110-111

! QDHQ? HH* ^L\[ () ,.5.)p eL;[ () '#,0&5 84'C#'I K:66fP

! Y&3&) Q.8.,.N(&5 *)+#,-.)8 H4'1#(55&),# KYBQ*HP

!

;;Ge^> ,.5.)! >fG>fe '#,0&5

P60.07*KX


37/56

*)=#3#)=#)0 '(82 +&,0.'8 8(N(5&' () ,.5.) &)=

'#,0&5 84'C#'(#8

Ikaght Hlktrlf Dlsp Gpibgnilf, Qlf. 87, Kl. 1 (Mukg ?052), pp. 110-111

*klt e risj ik rghtef surcgry


38/56

HH* '&0#8 3.80 ,F8#,-.) () & `66F9#= '#+#''&5 ".83(0&5

() ).'0"#') !&)R&)(&

Ektinihrlo _gsist Ikaght Hlktrlf. ?052 Euc 55:8=?7

! /#8&'#&) 8#,-.) '&0#8 &1#'&C# >^[ C5.9&55I K>L\ 0. ;6[P

! /H '&0#8 :>F]:[ () !&)R&)(&

! HH* '&0#8 () /H '&)C# +'.N 6L] 0. :;[

! ];^ 3&-#)08 #)'.55#= .1#' ^ N.)0"8 K:6>>F:6>:P! HH* '&0# >>Lf[ +.55.7()C #N#'C#)0p R#'. &y#' #5#,-1#


39/56

*)=#3#)=#)0 '(828 .+ HH* +.55.7()C ,F8#,-.)

Ektinihrlo _gsist Ikaght Hlktrlf. ?052 Euc 55:8=?7


40/56

E. 7# )##= &)-9(.-,8 &y#' ,".5#,I80#,0.NI () N(5=

0. N.=#'&0# &,40# ,&5,45.48 ,".5#,I8--8z

MENE. ?052:85?(?)=527-572.

! BN.RF/5&1 !*E 3'#F.3G .),# ()0'&F.3#'&-1#5I

! i3#)F5&9#5 '&)=.N(R&-.)? ^ =&I8 3.80F.3 &)-9(.-,8 18 ).)#

! ; 7##2 3.80F.3 +.55.7F43 +.' HH*

! ;>; 3&-#)08

! HH*? >^[ K&)-9(.-,8P 18 >e[ K). &)-9(.-,8P


41/56

V&,28 35&,#9. &)= "&8 & '#5&-1#5I 5&'C# ).)F

()+#'(.'(0I .40,.N# 0"'#8".5= K>>[P

MENE. ?052:85?(?)=527-572.


42/56

Z..' ,.N35(&),# &)= '#8(80&),# 7(0" N43('.,()G ,.45=

3.1(=.)#F(.=()# 9# &8 #X#,-1#z

IHDG, Qlf. 87, Kl. 3 (Mufy ?052), pp. 4?1-48?

! Z.1(=.)#F(.=()# :W 3'#F.3 18 ^ =&I8 N43('.,() g*E

!

B335(#= 07(,# 0. #&," ).80'(5

! B55 "&= /Da 7(3# 9&0"8 0"# )(C"0 9#+.'# &)= N.')()C .+ 84'C#'I

! Z'(N&'I .' '#1(8(.) &'0"'.35&80I .' 83()&5 +48(.)

! @.=(m#= ()0#)-.)F0.F0'#&0

! @43('.,() F =##3 HH* >; .+ f^^ K>L\[P

! Z.1(=.)#F(.=()# o =##3 HH* \ .+ f;: K6Le[PG 3l6L>


43/56


44/56

D.7 N4," "&)= "IC(#)# (8 C.()C .)G &)= 7"#'#z

IHDG 87=3 (Mufy ?052), pp. 4?1-48?

! :^e "'8G >\6^ .33.'04)(-#8

! ee[ OQG f[ @E8

! @#&) ;L: .3_".4'

! >6L;_"' Q*/S

! >]L:_"' @H*/S

! *8.5&0#= 3&-#)08G {

()0#'&,-.)8 KOOl6L^^P

2?%

50%

9%89%


45/56

V.08 .+ "&)= "IC(#)# .33.'04)(-#8 C.()C .)

En M Ikaght Hlktrlf. ?052 Muk:2?(1)=10?-3

! >: 9#=8 () C#) N#= 7&'=

! A(=#. o ^ N.N#)08

! e: .3_3&-#)0_=&I

! K] .3_=&IP

!

e^[ OQG ^[ @E

! *+ :66G666 3&-#)0 =&I8

! >^ N(55(.)_I#&'ddd


46/56

H.,(&5 )#07.'2 .' h3##'b #X#,08 () "&)= "IC(#)#

IHDG Qlf. 87, Kl. 50 (Lhtlogr ?052), pp. 5?33-5?47

!

/480.N "&)= "IC(#)# /0&'5'(( N.)(0.'()C 8I80#N

! E#0#,0 (+ D/c 3'&,-,#= #)0'I_#W(0 "&)= "IC(#)#

!


47/56

c>@ l ,.F7.'2#'8 #),.4)0#'#= () > N()40#

HOHH* l 84N .+ '#,#(1#= 8(C)&5 80'#)C0"

=A?! 5>"L Ze0 L QS _J)9>N&' TSQ\X0 HHL QTYYKQToe

S5N* > ?

X_XXI > 8 ukits

S5N* > ?

X_XXI > ? ukits

S5N* > 5

X_XXI>? ukits

hA#')"& >( 1'>4(2 '&H'&;&(9; Q C#(49&


48/56

Q.0 N4," "&)= "IC(#)# 940 3##' #X#,08

N&T#'

! >:G`>` DD #1#)08 _ ;e\`; .33.'04)(-#8 l ,.N35(&),# :e[

! c>@ N#&) :L`: K]L] =&IG :L^ )(C"0P

! /.N35(&),# :6Lf[ Kc>@l6PG :eL`[ Kc>@v6PG 3q6L6>

! HOHH* N#&) ]:`L`: K]e: =&IG :f^ )(C"0P

=A?! 5>"L Ze0 L QS _J)9>N&' TSQ\X0 HHL QTYYKQToe


49/56

*N3'.1()C "&)= "IC(#)# .407#(C"8 (N3'.1()C

0#'N()&5 ,5#&)()C () @EOi 3'#1#)-.)

IHDG ?052 Xgp:87(9)=5571-1?

!

BC#)0F9&8#= N.=#5? "&)= "IC(#)# 18 0#'N()&5 ,5#&)()C

! !'&)8N(88(.) .+ @OHBG AO6[ D&)= DIC(#)#


50/56

D&1# 7# 9##) .1#'1&54()C 9#=F=&I8 () ".83(0&58z


! D.7 N4," & 9#=F=&I (8 7.'0" 0. & ".83(0&5 ,&) 9# & ,'(-,&5

3&'&N#0#' +.' =#0#'N()()C 0"# ,.808 .+ (),(=#)0 DB*

! B,,.4)-)C N#0".= Fv D.83(0&5 94=C#0 =(1(=#= 9I 3'.1(=#= 9#=F=&I8

! c(55()C)#88 0. 3&I Fv ,.)-)C#)0 1&54&-.)G ".7 N4," 0"#IU= 3&I 0. 5(9#'&0# & =&I

! !7. H4'1#I8 o N&W(N4N 3&I &)= 8,#)&'(. 9&8#= K>>


51/56

c"(," N#0".= I.4 ,".8# 3'.+.4)=5I &50#'8

".7 I.4 1&54# ".83(0&5 9#=F=&I8



52/56

H".45= 8.,(#0I ()1#80 () 3'.C'&N8 0&'C#-)C /VBgH*

&)= ABZ 3'#1#)-.)

EMIH ?057 Mek:28(5)=2-9

! @.=#5 &T'(940&95# 5.)CF0#'N K5(+#-N#P .40,.N#8 +.' 8.,(#0I .+

3'#1#)-)C DB* () */S 8#s)C8

!

H(W =(8,'#0# 80&0#8 3.80F*/S =(8,"&'C# 48()C @#=(,&'# 3&'&N#0#' =&0&! i40,.N#8? /.80 3#' 5(+#FI#&' &)= /.80_}BV%

! *)0#'1#)-.) &)= .40,.N#8 '#3.'0#= &0 */S 5#1#5


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V.)C &)= 8".'0F0#'N N.=#58 .+ DB* 3'#1#)-.)

()0#'1#)-.)8 &)&5IR#= &0 0"# */S 5#1#5

EMIH ?057 Mek:28(5)=2-9


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*)+#,-.) Z'#1#)-.) (8 /.80F


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Rdekj ylu


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J(80 94N38 &)= 7#&2 "&)=8"&2#8 .)5I~

N f t f EMIH 2? (4) 951 3 E t ?052

best of infection control: 2015 eccmid

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