|本期目录/Table of Contents|

[1]陈菲,戚少云,冯文婷.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[J].传染病信息,2018,02:161-164,188.
 CHEN Fei,QI Shao-yun*,FENG Wen-ting.Effect of one year's comprehensive intervention measures of multidrug-resistant bacteria management by a general hospital[J].Infectious Disease Information,2018,02:161-164,188.
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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(PDF)

《传染病信息》[ISSN:1007-8134/CN:11-3886/R]

期数:
2018年02期
页码:
161-164,188
栏目:
论著
出版日期:
2018-03-20

文章信息/Info

Title:
Effect of one year's comprehensive intervention measures of multidrug-resistant bacteria management by a general hospital
作者:
陈菲戚少云冯文婷
237000,安徽医科大学附属六安市人民医院医 院感染管理办公室(陈菲、戚少云),检验科(冯文婷)
Author(s):
CHEN Fei QI Shao-yun* FENG Wen-ting
Hospital Infection Management Office, Lu'an Affiliated Hospital of Anhui Medical University, 237000, China
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
Keywords:
nosocomial infection multidrug-resistant bacteria antimicrobial agents infection control comprehensive intervention
分类号:
R197.323;R446.5
DOI:
10.3969/j.issn.1007-8134.2018.02.016
文献标识码:
A
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 spectrum β-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。 
Abstract:
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 spectrum β-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 significant (P > 0.05). Conclusions The rational use of antibiotics, reducing the usage rate of antibiotics, and implementing prevention and control measures in the wards can effectively reduce the incidence of nosocomial infections caused by multidrug-resistant bacteria.  

参考文献/References

[1] 林小春. 美国公布抗击耐药细菌国家行动计划[EB/OL].
[2017- 12-28]. http://www.chinanews.com/gj/2015/03-28/7166391.shtml.
[2] 佚名. 遏制细菌耐药国家行动计划(2016-2020 年)[J]. 药 物不良反应杂志, 2016,18(5):398-400.
[3] 黄勋,邓子德,倪语星,等. 多重耐药菌医院感染预防与控 制中国专家共识[J]. 中国感染控制杂志,2015,14(1):1-9.
[4] 中华人民共和国卫生部. 医院感染诊断标准(试行)[J]. 中 华医学杂志,2001,81(5):314-320.
[5] 张淑敏,朱熠,陈旭,等. 三级综合医院多药耐药菌监测数 据分析及干预措施评价[J]. 中华医院感染学杂志,2013, 23(7):1659-1661.
[6] 叶倩,杨莹,王善梅. 多重耐药菌目标性监测结果分析及效 果评价[J]. 预防医学情报杂志,2016,32(10):1041-1044.
[7] 雷曦兵,陈丽萍,肖亚雄,等. 某三级甲等医院实施多重耐 药防控干预效果研究[J]. 华西医学,2016,31(3):409-413.
[8] 刘仕莲,冷小艳. 手卫生依从性对ICU 多重耐药菌感染发病 率影响的研究[J]. 医药前沿,2016,6(7):28-30.
[9] 申桂娟,吴利和,陆军,等. 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[J]. 中华医院感染学杂志, 2016,26(4):950-952.
[10] 刘波,张卫红,李松琴,等. 提高微生物标本送检率的临床 效果评价[J]. 中国感染控制杂志,2016,15(11):862-864.
[11] 施倩妮,王喆,黄磊, 等. 2010-2014 年耐碳青霉烯类肠 杆菌的耐药性分析[J]. 中华医院感染学杂志,2016, 26(12):2657-2659,2737.
[12] Pitout JD, Nordmann P, Poirel L. Carbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance[J]. Antimicrob Agents Chemother, 2015, 59(10):5873-5884.
[13] 林迪,孙长贵. 碳青霉烯类耐药肠杆菌科细菌的研究进展[J]. 传染病信息,2017,30(5):257-261,271.
[14] 刘萍,向书蓉. 综合医院多重耐药菌目标性监测与分析[J]. 现代预防医学,2015,42(2):362-365,371.

备注/Memo

备注/Memo:
[通信作者] 戚少云,E-mail: 1365744461@qq.com
更新日期/Last Update: 2018-03-20