强化终末消毒降低重症监护病房多重耐药菌医院感染的研究  

Study on strengthening terminal disinfection to reduce the nosocomial infection of multi-drug resistant organisms in intensive care unit

作　　者：孙渭歌 王文文 郭东玲 杜鹃 阎颖 贾美云 SUN Wei-ge;WANG Wen-wen;GUO Dong-ling;DU Juan;YAN Ying;JIA Mei-yun(People's Hospital of Henan University of Chinese Medicine People's Hospital of Zhengzhou,Zhengzhou Henan 450003,China;The Fifth Clinical Medical College of Henan University of Chinese Medicine)

机构地区：[1]河南中医药大学人民医院郑州人民医院,河南郑州450002 [2]河南中医药大学第五临床医学院

出　　处：《中国消毒学杂志》2024年第5期371-374,共4页Chinese Journal of Disinfection

基　　金：河南省医学科技攻关计划项目(LHGJ20191082)。

摘　　要：目的评估强化终末消毒对多重耐药菌(MDRO)医院感染的影响。方法回顾性调查2017—2019年的数据作为干预前组,前瞻性监测2020—2021年的数据作为干预后组,对比干预前后MDRO感染发现率、菌种构成比和检出率。结果对某基层ICU医疗区在常规消毒的基础上联合汽化过氧化氢技术进行强化终末消毒,干预后MDRO感染发现率(1.84%)低于干预前(2.83%)(P<0.05);干预后多重耐药鲍曼不动杆菌(MDRAB)、耐碳青霉烯类黏质沙雷菌(CRSM)的构成比和医院感染检出率下降(P<0.05);耐碳青霉烯类肺炎克雷伯菌(CRKP)医院感染检出率差异没有统计学意义,但是构成比有所上升(P<0.05)。结论强化终末消毒能够降低MDRO引起的医院感染,但需要关注耐碳青酶烯类肠杆菌(CRE),尤其是CRKP引起的医院感染。Objective To evaluate the effect of intensive terminal disinfection on nosocomial infection of multi-drug resistant orgamisms(MDRO).Methods The data from 2017 to 2019 were retrospectively investigated as the preintervention group,and the data from 2020 to 2021 were prospectively monitored as the post-intervention group.The discovery rate,bacteria composition ratio,and detection rate of MDRO nosocomial infection before and after intervention were compared.Results On the basis of routine disinfection in a primary intensive care unit(ICU)medical area,vaporized hydrogen peroxide technology was used to strengthen the terminal disinfection.The discovery rate of MDRO nosocomial infection after intervention was 1.84%,which was lower than 2.83%before intervention(P<0.05).After the intervention,the constituent ratio of multidrug-resistant Acinetobacter baumannii(MDRAB)and carbapenem-resistant Serratia marcescens(CRSM)and the detection rate of nosocomial infection decreased(P<0.05).The detection rate of nosocomial infection caused by carbapenem-resistant Klebsiella pneumoniae(CRKP)did not increase statistically,but the constituent ratio increased(P<0.05).Conclusion Intensive terminal disinfection can reduce nosocomial infections caused by MDRO,but we need to pay attention to nosocomial infections caused by carbapenem-resistant Enterobacteriaceae(CRE),especially CRKP.

关 键 词：ICU 强化终末消毒 多重耐药菌 医院感染 

分 类 号：R184[医药卫生—流行病学]