某综合医院多药耐药菌医院感染干预效果分析  

Effect of interventions to control of nosocomial infections caused by multidrug-resistant bacteria in a general hospital

作　　者：赵艳春[1] 贾建侠[1] 赵秀莉[1] 任军红[1] 贾会学[1] 姚希[1] 殷环[1] 李六亿[1] 

机构地区：[1]北京大学第一医院感染管理-疾病预防控制处,北京100034

出　　处：《中华医院感染学杂志》2014年第21期5271-5273,共3页Chinese Journal of Nosocomiology

基　　金：中美新发和再发传染病合作基金资助项目(5U2GGH000018)

摘　　要：目的了解某综合医院住院患者医院感染多药耐药菌(MDROs)干预效果。方法前瞻性调查某医院2011-2013年多药耐药菌医院感染(MDROs-HOI)患者临床资料,采取加强手卫生、接触隔离等预防医院感染干预措施,每月及每年对全院各科MDROs-HOI病例进行分析并临床反馈,对存在问题持续质量改进。结果调查期间全院共收治188 245例患者,总住院日1 702 830d,共发生705例MDROs-HOI;2011-2013年全院MDROs-HOI千日感染率由0.48‰降至0.31‰,连续两年显著下降,差异有统计学意义(χ2=20.15,P<0.05);各临床科室中ICU及内科MDROs-HOI控制成效显著;ICU MDROs-HOI千日感染率2013年2.11‰比2011年的4.82‰显著下降(χ2=23.17,P<0.05);内科2013年0.31‰较2012年的0.49‰显著下降(χ2=8.06,P<0.05);外科、妇产科、儿科、五官科及皮科MDROs-HOI千日感染率均有下降。结论通过实施干预措施可显著控制全院MDROs-HOI,特别是ICU及内科MDROs-HOI控制成效显著,为降低MDROs-HOI、促进抗菌药物合理使用提供参考。OBJECTIVE To explore the effect of interventions to the control of multidrug-resistant organisms （MDROs ） infections in hospitalized patients of a general hospital .METHODS The prospective survey was conducted for the clinical data of the patients with MDROs infections who were hospitalized from 2011 to 2013;the intervention measures such as strengthening hand hygiene and contact isolation were taken to prevent the nosocomial infections ,the MDROs infections patients in the departments of whole hospital were analyzed in each month and each year ,and the clinical feedback was conducted ;the continuous quality improvement of the existing problems was carried out .RESULTS A total of 188 245 patients who were treated in the hospital were included in the survey ,with the total length of hospital stay of 1 702 830 days;the MDROs infection occurred in 705 case-times of patients in total .From 2011 through 2013 ,the thousand day rate of the MDROs infections decreased from 0 .48‰ to 0 .31‰ ,showing a remarkable decrease in the two consecutive years ,there was statistically significant difference （χ2 =20 .15 ,P〈 0 .05） .Among the clinical departments ,the ICUs and internal medicine departments have achieved remarkable effectiveness in the control of MDROs infections .The thousand day rate of the MDROs infections in the ICUs significantly decreased from 4 .82‰ in 2011 to 2 .11‰ in 2013 （χ2 =23 .17 ,P〈0 .05）;the thousand day rate of the MDROs infections significantly decreased from 0 .49‰ in 2012 to 0 .31‰ in 2013 （χ2 = 8 .06 ,P〈 0 .05 ）;the thousand day rate of the MDROs infections was decreased in the surgery department ,gynecology and obstetrics department ,pediatrics department ,ENT department ,and dermatology department .CONCLUSION The implementation of the intervention measures can achieve significant effect on the control of the MDROs infections in the whole hospital ,especially in the ICUs and internal medicine department ,which may contribute to the reduction of incidence of the

关 键 词：多药耐药菌 医院感染 干预效果 

分 类 号：R978.1[医药卫生—药品]