神经内科重症监护室多重耐药铜绿假单胞菌院内下呼吸道感染的调查分析及控制对策  

The investigation and control measures on the nosocomial infection of multidrug resistant pseudomonas aeruginosa in the neurological intensive care unit

作　　者：许波银[1] 顾萍[1] 邵苏吉[1] 

机构地区：[1]南通大学附属医院感染管理科,南通226001

出　　处：《南通大学学报（医学版）》2012年第1期41-43,共3页Journal of Nantong University(Medical sciences)

摘　　要：目的:调查和分析神经内科监护病房(NICU)多重耐药铜绿假单胞菌(MDR-PA)医院感染的原因,探讨有效的防控对策。方法:对NICU 2010年2月-2010年7月入住NICU患者发生下呼吸道MDR-PA感染进行流行病学调查。结果:呼吸机混用及使用后欠缺合格的清洗消毒、病室卫生环境差及患者隔离困难、循环风动态空气消毒机故障以及医务人员诊间洗手执行不力等是引起NICU患者发生下呼吸道MDR-PA感染的主要原因;气管侵入性操作、长期使用广谱抗菌药物和患者自身基础疾病等是引起NICU患者发生下呼吸道MDR-PA感染的危险因素。结论:加强呼吸机的管理,密切注意病室空气质量,严格隔离患者,加强手卫生的管理和培训,对入住患者进行多重耐药菌的筛查,尽早采取相应的接触隔离,是预防和控制多重耐药菌感染或蔓延的有效措施。Objective： To investigate and analyze reasons for the nosocomial infection of MDR-PA in NICU,and probe the effective polices for the relevant preventions.Methods： An epidemiological investigation was performed on patients with lower respiratory tract infection of MDR-PA in NICU from February 1 to January 31,2010.Results： The intermixed ventilators and improper cleaning and disinfection after using them,poor hygienic conditions of ward and difficulty in patients＇ isolation;malfunction of circulatory dynamic air disinfecting machines,weak enforcement of hand washing among medical staff during service time causing the major reasons for patients with lower respiratory tract infection of MDR-PA in NICU,invasive operations of endotracheal intubation and tracheotomy and so on,long-term empirical use of various antibiotics,risk factors such as the patient＇s own underlying diseases for those with lower respiratory tract infection of MDR-PA in NICU.Conclusion： It is advisable to strengthen the management of ventilator and pay close attention to the air quality of ward.Besides,the strict isolation of patients and strengthening the management and training of hand hygiene are preferable.Moreover,the screening of the admitted patients with multi-drug resistant bacteria,taking the appropriate measures to contact isolation,and prevention and control of the spread of multi-drug resistant infections are desirable as well.

关 键 词：重症监护病房 铜绿假单胞菌 医院感染 

分 类 号：R378[医药卫生—病原生物学] R56[医药卫生—基础医学]