医院感染监测系统精准手卫生干预对多药耐药菌感染的防控效果  

Effect of precise hand hygiene intervention based on nosocomial infection surveillance system on prevention and control of multidrug-resistant organisms

作　　者：沈小玥 苏欣 董维鹏 戚瑾 黄慧敏 李亚楠 尹诺 方红梅 SHEN Xiao-yue;SU Xin;DONG Wei-peng;QI Jin;HANG Hui-min;LI Ya-nan;YIN Nuo;FANG Hong-mei(General Hospital of Eastern Theater Command PLA,Nanjing,Jiangsu 210002,China;不详)

机构地区：[1]东部战区总医院疾病预防控制科,江苏南京210002 [2]南京鼓楼医院呼吸与危重症医学科,江苏南京210002

出　　处：《中华医院感染学杂志》2024年第17期2693-2697,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金面上项目(82070011)。

摘　　要：目的采用医院感染实时监控软件对重症监护病房(ICU)多药耐药菌(MDROs)动态监测,精准干预手卫生,观察对MDROs防控的效果。方法自2023年1月-12月在某综合性三甲医院普外科采用医院感染软件“杏林医院感染实时监控系统”对ICU患者从入院到出院的全程在线动态监测,一旦患者检测出MDROs感染或定值立即对相关医护人员、护工、保洁人员、患者及患者家属的手卫生进行精准干预。结果手卫生进行精准干预后,护工、患者、患者家属和医务人员手卫生依从性及手卫生合格率均明显升高(P<0.05);医院感染发病率(9.19%vs.4.47%),尤其是MDROs感染率(5.29%vs.1.26%)明显下降(P<0.05);耐甲氧西林金黄色葡萄球菌(MRSA)、耐碳青霉烯铜绿假单胞菌(CRPA)、耐碳青霉烯鲍氏不动杆菌(CRAB)和耐碳青霉烯肠杆菌(CRE)检出率下降(P<0.05),其中MRSA检出率明显下降(63.64%vs.5.56%)。结论采用医院感染实时监控软件对ICU MDROs动态监测,精准干预手卫生,可以明显提高相关医护人员、患者和患者家属、护工、保洁人员的手卫生依从性,从而使MDROs医院感染发病率降低,提升MDROs防控效果。OBJECTIVE To carry out the dynamic surveillance of multidrug-resistant organisms(MDROs)from intensive care unit(ICU)by using nosocomial infection real-time surveillance software,take precise hand hygiene intervention measures and observe the effect on prevention and control of MDROs.METHODS From Jan 2023 to Dec 2023,the nosocomial infection software"Xinglin Nosocomial Infection Real-time Surveillance System"was adopted by general department of a three-A general hospital,a whole process online dynamic surveillance was carried out from the admission to hospital to the discharge.The precise intervention measures were taken for health care workers,nursing staff,cleaning staff,patients and patients′family as soon as the MDROs infection or colonization was detected among the patients.RESULTS The hand hygiene compliance and qualified rate of hand hygiene of the nursing staff,patients and patients′family were significantly increased after the precise intervention measures were taken(P<0.05).The incidence of nosocomial infection(9.19%vs.4.47%),the MDROs infection(5.29%vs.1.26%)in particularly,was significantly reduced(P<0.05).The isolation rates of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Pseudomonas aeruginosa(CRPA),carbapenem-resistant Acinetobacter baumannii(CRAB)and carbapenem-resistant Enterobacteriaceae(CRE)were decreased(P<0.05),and the isolation rate of MRSA was significantly decreased(63.64%vs.5.56%).CONCLUSION The dynamic surveillance of MDROs is carried out for ICU patients by using nosocomial infection real-time surveillance software,the precise hand hygiene intervention measure are taken,which can significantly improve the hand hygiene compliance of the health care workers,patients,patients′family,nursing staff and cleaning staff,reduce the incidence of MDROs infection,and boost the effect of prevention and control of MDROs.

关 键 词：医院感染监测 手卫生 干预 多药耐药菌 预防与控制 

分 类 号：R181.32[医药卫生—流行病学]