高频接触物体表面消毒质量管理在多药耐药菌控制中的作用研究  

Effect of disinfection quality management of ICU high-touch surface on the control of multi drug resistant bacteria

作　　者：申桂娟[1] 吴利和[1] 陆军[1] 吴霞云[1] 沈红艳[1] 孙平平[1] 汪锡耀[1] 祝进[1] 

机构地区：[1]衢州市人民医院感染管理处,浙江衢州324000

出　　处：《中华医院感染学杂志》2016年第4期950-952,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(LY13H200004)

摘　　要：目的探讨ICU高频接触物体表面消毒质量管理在多药耐药菌控制中的作用,以提高医疗质量。方法选择2013年5月-2014年12月ICU 1 297例住院患者的多药耐药菌检出结果为研究对象,将2013年5月-2014年2月住院患者594例设为干预前组,2014年3-12月住院患者703例设为干预后组,由责任护士负责组内高频接触物体表面的消毒,并规范消毒方法和消毒质量的督查,比较两组的消毒质量和多药耐药菌检出结果。结果高频接触物体表面消毒质量在干预前后合格率分别为80.3%和94.3%,差异有统计学意义(P<0.05);干预前后目标性病原菌监测多药耐药菌检出率分别为77.9%和37.5%,差异有统计学意义(P<0.05);ICU患者目标性病原菌监测多药耐药菌检出率在干预前后分别为45.2%和26.3%,其中耐甲氧西林金黄色葡萄球菌、耐碳青霉烯类肺炎克雷伯菌和泛耐药鲍氏不动杆菌检出率显著下降,差异有统计学意义(P<0.05)。结论重视并规范高频接触物体表面消毒质量管理,能有效控制多药耐药菌在医院内的传播。OBJECTIVE To investigate the effect of disinfection quality management of ICU high-touch surface on the control of multi drug resistant bacteria so as to improve medical quality.METHODS Totally 1297 hospitalized patients in ICU with multi drug resistant bacteria detection from May 2013 to Dec.2014 were selected,594 cases from May 2013 to Feb.2014 were set as the control group,703 cases from Mar.to Dec.2014 as the intervention group,in which the responsibility nurses were responsible for high-touch surface disinfection,stadardization of disinfection methods and quality management.The disinfection quality and the detection results of drug resistant bacteria were compared between two groups.RESULTS The qualified rate of disinfection quality in high-touch surface was 80.3% and 94.3% respectively before and after intervention,and the difference was significant（P0.05）.Target pathogen monitoring showed the detection rates of multi drug resistant bacteria in two groups were77.9% and 37.5% respectively,and the difference was significant（P 0.05）.The target pathogen monitoring showed the detection rates of multi drug resistant bacteria before and after the intervention for ICU patients were45.2% and 26.3%,in which the detection rates of methicillin-resistant Staphylococcus aureus,carbapenems-resistant Klebsiella pneumoniae and pan drug resistant Acinetobacter baumann were significantly decreased（P0.05）.CONCLUSION The quality management of disinfection of high-touch surface can effectively control the spread of multi drug resistant bacteria in the hospital.

关 键 词：高频接触物体表面 消毒质量 多药耐药菌 控制 

分 类 号：R187[医药卫生—流行病学]