重症监护病房多药耐药菌目标性监测与干预措施的研讨

Intervention and targeted monitoring to multidrug-resistant organism in ICU

目的对重症监护病房(ICU)多药耐药菌采取目标性监测,评价干预措施的效果,探讨多药耐药菌的干预措施。方法 2009年10月-2010年12月开展ICU多药耐药菌目标性监测,实施干预,包括宣教和培训、设计多药耐药菌登记本,采取接触隔离预防控制措施,每日通过LIS系统监测ICU多药耐药菌,并到ICU督察实施。结果多药耐药菌构成比卡方检验,2009年与2010年季度间差异有统计学意义;多药耐药菌占病原学的34.91%,主要为泛耐药铜绿假单胞菌(PDRPA)、泛耐药鲍氏不动杆菌(PDRAB)、产ESBLs的大肠埃希菌,97.64%为痰标本。结论对ICU多药耐药菌干预措施有效,还需加强抗菌药物合理应用的管理、多药耐药菌主动筛查等。

OBJECTIVE To make objective monitoring to multidrug-resistant organism（MDRO） in intensive care unit（ICU）,to study and evaluate intervention measures.METHODS From Oct 2009 to Dec 2010,we have developed an objective monitoring and interventional measures to MDRO of ICU,including education and training,design register notebook,doctor＇s orders,contact isolation and precaution,looking daily MDRO by LIS system and superintend to ICU,statistical analysis.RESULTS To constituent ratio of MDRO by chi square test,the difference between 2009 and 2010,there was a statistical significance;MDRO accounted for 34.91%,which mainly including PDR-PA,PDR-AB and E.coli of ESBLs positive,97.64% was sputum specimen.CONCLUSION It is effective that making intervention to MDRO,at the same time,it is important to strengthen management of antibacterials rational use and active screening to MDRO.