主动筛查与组合干预对ICU多药耐药菌感染患者的效果评价  

Effect of active screening plus integrated intervention on prevention of multidrug-resistant organisms infections in ICU patients

作　　者：唐红萍[1] 高晓东[2] 樊春笋[3] 孙赛赛[1] 张亚玮[3] 

机构地区：[1]启东市人民医院感染管理科,江苏启东226200 [2]复旦大学附属中山医院感染管理科,上海200032 [3]启东市人民医院病因室,江苏启东226200

出　　处：《中华医院感染学杂志》2015年第11期2484-2486,共3页Chinese Journal of Nosocomiology

基　　金：国家科技重大专项基金资助项目(2013ZX10004217005)

摘　　要：目的了解主动筛查与组合干预对多药耐药菌(MDROs)感染患者的实施成效,为制定科学有效的MDROs预防控制策略提供依据。方法采用目标性监测结合组合干预策略,选择2014年10月-2015年2月入住医院综合ICU>24h的患者374例为干预组,在MDROs主动筛查基础上推行组合干预措施,与该ICU2014年5-9月未实施组合干预的患者365例为常规组比较,观察两组患者医院感染调整日感染率、MDROs医院感染构成比、MDROs例次感染率、MDROs千日感染率、呼吸机相关性肺炎(VAP)千日感染率等变化。结果两组共监测患者739例,住院总日数1 664d;常规组、干预组医院感染率分别为3.29%、2.14%,例次感染率分别为3.56%、2.14%,日感染率分别为16.24‰、8.65‰,例次日感染率分别为17.59‰、8.65‰;MDROs医院感染为61.53%、25.00%;MDROs医院感染例次发生率为2.19%、0.53%;MDROs千日感染率为10.83‰、2.16‰;VAP千日感染率分别为34.09‰、11.44‰,与常规组比较,干预组各项感染率均有下降;MDROs千日感染率、VAP千日感染率差异有统计学意义(P<0.05)。结论推行主动筛查及组合干预技术预防控制多药耐药菌感染实施有效,可在临床推广。OBJECTIVE To understand the effect of active screening plus integrated intervention on prevention of the multidrug‐resistant organisms （MDROs） infections in the ICU patients so as to put forward scientific and ef‐fective strategies for prevention of the MDROs infections .METHODS By means of targeted surveillance combined with integrated interventions ,totally 374 patients who were hospitalized the general ICU for more than 24 hours from Oct 2014 to Feb 2015 were chosen as the intervention group and were treated with integrated intervention technique based on the active screening of MDROs ,while 365 patients who were hospitalized the ICU from May to Sep 2014 and were not treated with the integrated intervention were set as the conventional group .The adjusted infection rate ,constituent ratios of MDROs infections ,case‐time rate of MDROs infections ,thousand‐day rate of MDROs infections ,and thousand‐day rate of ventilator‐associated pneumonia （VAP） were observed and compared between the two groups .RESULTS A total of 739 patients were monitored in the two groups ,and the total length of hospital stay was 1 664 days .The incidence of nosocomial infections was 3 .29% in the conventional group , 2 .14% in the intervention group ;the case‐time infection rate was 3 .56% in the conventional group ,2 .14% in the intervention group ;the daily infection rate was 16 .24‰ in the conventional group ,8 .65‰ in the intervention group;the case‐time daily infection rate was 17 .59‰ in the conventional group ,8 .65‰ in the intervention group . The incidence of MDROs infections was 61 .53% in the conventional group ,25 .00% in the intervention group ;the thousand‐day rate of MDROs infections was 10 .83‰ in the conventional group ,2 .16‰ in the intervention group;the thousand‐day infection rate of VAP was 34 .09‰ in the conventional group , 11 .44‰ in the intervention group .As compared with the conventional group ,the infection rates of the intervention group were reduced ;there was sign

关 键 词：医院感染 多药耐药菌 主动筛查 组合干预技术 

分 类 号：R181.32[医药卫生—流行病学]