机构地区:[1]十堰市太和医院,湖北十堰442000 [2]武汉大学人民医院,湖北武汉430060 [3]武汉市疾病预防控制中心,湖北武汉430015 [4]华中科技大学同济医学院附属同济医院,湖北武汉430030 [5]华中科技大学同济医学院附属协和医院,湖北武汉430030
出 处:《中国感染控制杂志》2017年第8期717-720,共4页Chinese Journal of Infection Control
基 金:湖北省教育厅科研项目(B20112119);十堰市科学技术研究与开发项目(2010st16);湖北医药学院附属太和医院博士科研启动项目(2011QD06)
摘 要:目的了解湖北省医疗机构医院感染管理基本情况和多重耐药菌感染防控现状。方法采用问卷调查方式对湖北省47所三级和二级医院进行医院感染管理基本情况和多重耐药菌感染现状的调查。结果 47所医院中,医院感染管理专职人员配备中位数为0.90人/250床;2015年耐甲氧西林金黄色葡萄球菌、耐碳青霉烯类肠杆菌、耐碳青霉烯类铜绿假单胞菌、耐碳青霉烯类鲍曼不动杆菌、耐万古霉素肠球菌检出率分别为39.13%、4.13%、19.44%、63.60%、2.77%。47所医院均开展了多重耐药菌监测,共有28所(59.57%)医院安装了医院感染监测系统软件,同时与检验系统对接可直接获得数据。多重耐药菌感染诊断方式中以医院感染专职人员和临床医生共同诊断为主(26所,占55.32%)。44所(93.62%)医院均定期召开多重耐药菌防控协调会,2015年全院自查手卫生依从率为10.0%~89.2%;42所(89.36%)医院对多重耐药菌感染患者常规开具隔离医嘱,33所(70.21%)医院环境清洁消毒频次2次/d,24所(51.06%)医院采用全套的防护物品进行个人防护。结论此次调查有助于了解医疗机构医院感染管理工作的总体情况,掌握该地区多重耐药菌检出和防控情况。针对调查项目发现的问题和薄弱环节进行持续改进,有助于推动该地区医院感染管理工作的良性发展。Objective To understand the basic situation of healthcare-associated infection(HAI) management and prevention and control of multidrug-resistant organism(MDRO) infection in medical institutions in Hubei Province. Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province. Results 47 hospital were enrolled in this study, HAI management full-time staff was allocated with a median of 0. 90/250 beds; in 2015, the isolation rates of methicillinresistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudornonas aeruginosa, carbapenem-resistant Acinetobacter baumannii, and vancomycin-resistant Enterococcus were 39. 13 %,4.13%, 19.44%, 63.60%, and 2.77% respectively. 47 hospitals all carried out surveillance on MDROs, 28(59. 57%) hospitals were installed HAI monitoring system software, could directly obtain data through collecting with the laboratory system. The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full time personnel and clinicians(26 hospitals, 55.32 %). 44 (93.62 % ) hospitals regularly convened coordination meeting on prevention and control of MDROs, in 2015, hand hygiene compliance rate were 10.0% - 89.2% by self-in spection; 42 (89. 36%) hospitals routinely prescribed isolation orders for patients with MDRO infection, 33 (70. 21%) hospitals conducted environmental clean and disinfection twice a day, 24 (51.06 % ) hospitals performed personal protection by using complete set of protective equipment. Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions, as well as the detection and control of MDROs in this area, and make continual improvement on the problems and weakness found in the investigated project, so as to promote the development of HAI management in this area.
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