感控干预在控制多重耐药定植菌医院感染的临床研究

Infection control interventions in clinical study of multi-drug resistant bacteria colonization and control of hospital infection

目的研究多重耐药定植菌与医院感染的关系以及去定植措施的效果。方法对入住ICU的患者进行多重耐药定植菌筛查,观察阳性患者和阴性患者医院感染发生率;将阳性患者随机分为对照组和试验组,对照组采用常规的预防控制措施,试验组加上安尔碘Ⅲ去鼻腔MRSA、口服金双歧去肠道产ESBLs肠杆菌措施,观察两组患者医院感染发生率以及定植菌与医院感染的关系,对比两组去定植效果。结果 ICU多重耐药菌定植率为31.16%;多重耐药定植菌筛查阴性患者医院感染率为7.56%,阳性患者医院感染率为15.47%(P<0.01);对照组医院感染率为20.79%,试验组医院感染率为22.22%(P>0.05);对照组定植菌医院感染率为4.95%,试验组定植菌医院感染为0(P<0.01);对照组产ESBLs大肠埃希菌定植自行清除率为26.31%,试验组产ESBLs大肠埃希菌去定植率为80.95%(P<0.01)。结论 ICU患者多重耐药菌定植率高,多重耐药菌定植患者医院感染率高,口服金双歧去肠道产ESBLs细菌干预措施有效,安尔碘Ⅲ去鼻腔MRSA效果需继续研究。

Objective To investigate the relationship between multidrug resistant bacteria colonization and hospital infection andthe effect of decolonization measures. Methods Patients of ICU in multiple drug-resistant bacteria colonization screening positive andnegative patients,observed the nosocomial infection rate ; the positive patients were randomly divided into the control group and the experi-mental group,the control group using conventional measures of prevention and control,experimental group with Anerdian IH to nasal MR-SA ,oral Jin Shuangqi to intestinal ESBLs producing Escherichia coli measures,two groups were observed in patients with nosocomial in-fection rate and bacteria colonization and infection in hospital, compared two groups of decolonization effect. Results ICU colonizationrate of multidrug-resistant bacteria was 31. 16% ; multidrug resistant bacteria colonization screening negative patients with nosocomial in-fection rate was 7. 56% , the positive patients with hospital infection rate was 15. 47% （P 〈0. 01） ; hospital infection rate was 20.19% incontrol group, the experimental group hospital infection rate was 22. 22% （P 〉 0. 05） ; the control group the colonization of bacteria innosocomial infection rate was 4. 95%,the experimental group colonization bacteria in nosocomial infection in 0 （P 〈0.01） ; control groupof ESBLs producing Escherichia coli colonization self clearance rate was 26. 31%,the experimental group of ESBLs producing Escherichiacoli to colonization rate was 80. 95% （P 〈0. 01 ） . Conclusion ICU patients with multi-drug resistant bacteria colonizationrate is high,the hospital of multi drug resistant bacteria colonization and infection rate in patients with high, oral Golden bifid to intestinal ESBLs pro-ducing bacteria effective intervention measures,the need to continue to study the effect of Anerdian Ⅲ to nasal MRSA.