某综合医院严格实施多重耐药菌管理综合干预措施1年效果观察  

Effect of one year's comprehensive intervention measures of multidrug-resistant bacteria management by a general hospital

作　　者：陈菲 戚少云[1] 冯文婷 CHEN Fei;QI Shao-yun;FENG Wen-ting(Hospital Infection Management Office,Lu'an Affiliated Hospital of Anhui Medical University,237000,China)

机构地区：[1]安徽医科大学附属六安市人民医院医院感染管理办公室,237000 [2]安徽医科大学附属六安市人民医院检验科,237000

出　　处：《传染病信息》2018年第2期161-164,188,共5页Infectious Disease Information

摘　　要：目的观察预防控制措施对降低多重耐药菌医院感染率的效果,为制定各项预防控制措施提供依据。方法我院于2014年12月开始严格实施多重耐药菌管理综合干预措施。选取2014年1月1日—2015年12月31日期间的住院患者,分别统计住院患者的抗菌药物使用率、抗菌药物使用强度及微生物标本送检率,对检出多重耐药菌感染或定植的住院患者,分别统计病房预防控制措施落实情况、多重耐药菌检出率及多重耐药菌医院感染率。结果与2014年数据相比,2015年我院抗菌药物使用率下降,治疗性使用抗菌药物的微生物标本的送检率均有上升;耐碳青霉烯类铜绿假单胞菌(carbapenem-resistant Pseudomonas aeruginosa,CRPA)、耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae,CRKP)的检出率明显下降,产超广谱β-内酰胺酶(extended spectrumβ-lactamases,ESBLs)肺炎克雷伯菌的检出率有所上升;隔离标识放置率、手卫生设施落实率、患者生活垃圾正确处置率均有上升;CRKP和产ESBLs肺炎克雷伯菌医院感染发生率下降,差异有统计学意义(P均<0.05);耐碳青霉烯类鲍曼不动杆菌、CRPA医院感染发生率下降,耐甲氧西林金黄色葡萄球菌、产ESBLs大肠埃希菌医院感染发生率上升,但差异无统计学意义(P均>0.05)。结论合理使用抗菌药物,降低抗菌药物使用率,落实病房预防控制措施可以有效的降低多重耐药菌医院感染率。Objective To investigate the effect of infection control interventions on reducing the infection rate of multidrugresistant bacteria in the hospital,and provide evidence for developing a variety of prevention and control measures.Methods Since December 2014,comprehensive intervention measures of multidrug-resistant bacteria management have been strictly implemented in Lu'an Affiliated Hospital of Anhui Medical University.The inpatients were included in this study from January 1,2014 to December 31,2015.According to the statistical results of the usage rate and use intensity of antibiotics,as well as the microbiology specimen submission rate,patients with multidrug-resistant infection or colonization were further analyzed.The implementation of prevention and control measures in wards,the detection rate of multidrug-resistant bacteria and the incidence of nosocomial infections caused by multidrug-resistant bacteria were respectively calculated.Results Compared with data in 2014,the usage rate of antibiotics in 2015 was decreased and the microbiology specimen submission rate was increased when patients were treated with antibiotics.The detection rate of carbapenem-resistant Pseudomonas aeruginosa(CRPA)and carbapenem-resistant Klebsiella pneumoniae(CRKP)were decreased significantly,while the detection rate of Klebsiella pneumoniae producing extended spectrumβ-lactamases(ESBLs)was increased.The placement rate of isolation signs,the implementation rate of hand hygiene facilities and the correct disposal rate of patients'living garbage were all increased.The incidence of nosocomial infections caused by CRKP and Klebsiella pneumoniae producing ESBLs were decreased,and the difference was statistically significant(P<0.05).The incidence of nosocomial infections caused by carbapenemresistant Acinetobacter baumannii and CRPA were decreased,and the incidence of nosocomial infections caused by methicillin-resistant Staphylococcus aureus and Escherichia coli producing ESBLs was increased,but the difference was not statistically

关 键 词：医院感染 多重耐药菌 抗菌药物 感染控制 综合干预措施 

分 类 号：R197.323[医药卫生—卫生事业管理] R446.5[医药卫生—公共卫生与预防医学]