规范医院感染管理降低多药耐药菌传播

Standardized nosocomial infection management to reduce dissemination of multidrug-resistant bacteria

目的加强合理用药、标准预防和接触隔离预防的实施,降低多药耐药菌的感染与传播。方法根据规范要求制定医院感染管理相关制度、流程,运用选择式目标管理,要求多药耐药菌隔离率≥85.0%;手消毒剂使用合格率≥80.0%;手术预防用药时机达标率≥80.0%。结果经多药耐药菌隔离、手卫生、手术预防用药的目标管理,产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌、ESBLs大肠埃希菌、耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRSCN)的感染分别由2006年的55.4%、50.7%、81.6%和83.0%下降至2010年的26.5%、43.8%、65.9%和62.4%。结论合理使用抗菌药物,规范隔离预防措施的实施是降低多药耐药菌感染的有效手段。

OBJECTIVE To reduce the infection and the dissemination of multidrug-resistant organisms by means of strengthening the reasonable use of antibiotics,standard prevention and contact isolation prevention. METHODS Hospital infection management associated system and pathway were established according to guideline requirement,selected target management was applied,the request MDRO isolation rate ≥85.0%;Hand disinfectant use qualified rate ≥80.0%;surgery preventive medication opportunity success rate ≥80.0%. RESULTS Through MDRO infected patient＇s isolation,hand health compliance enhancement and standard management of surgery preventive medication,the infection rates of extended spectrum beta-lactamases（ESBLs）producing-Klebsiella pneumoniae,ESBLs-Escherichia coli,methicillin-resistant Staphylococcus aureus（MRSA）,methicillin-resistant coagulative negative staphylococcus（MRSCN） decreased from 55.4%,50.7%,81.6% and 83.0% in 2006 to 26.5%,43.8%,65.9% and 62.4% in 2010 respectively. CONCLUSION The reasonable use of antibiotics and standard isolation prevention can reduce MDRO infection effectively.