多药耐药菌医院感染监控措施的临床实践

Clinical practice of monitoring of nosocomial infections caused by multidrug-resistant bacteria

目的了解多药耐药菌(MDROs)预防控制措施的有效性,降低医院感染率。方法对2010年1月-2011年12月医院耐碳青霉烯类鲍氏不动杆菌、多药耐药铜绿假单胞菌、产ESBLs大肠埃希菌和产ESBLs肺炎克雷伯菌菌株及其患者进行监测,通过干预,分析MDROs医院感染情况。结果耐碳青霉烯类鲍氏不动杆菌医院感染率分别为3.1%和1.7%,多药耐药铜绿假单胞菌医院感染率分别为2.6%和1.4%,其差异均有统计学意义(P<0.05);产ESBLs大肠埃希菌和产ESBLs肺炎克雷伯菌的医院感染率差异均无统计学意义。结论对MDROs感染或定植患者进行实时监控,实施标准预防,严格手卫生和消毒隔离制度等,能有效减少多药耐药菌医院感染的发生率。

OBJECTIVE To understand the effectiveness of prevention and control measures for multidrug-resistant organism （MDRO） infections so as to reduce the incidence of nosocomial infections. METHODS From Jan 2010 to Dec 2011, the carbapenem-resistant Acinetobactera baumannii, multidrug-resistant Pseudomonas aeruginosa, ESBLs-producing Escherichia coli, ESBLs-producing Ktebsiella pneumoniae as well as the patients were monitored, then the intervention measures were taken, and the incidence of MDRO infections was analyzed. RESULTS The incidence rates of nosocomial infections caused by carbapenems-resistant A. baumannii were 3.1 % and 1.7 %, respectively; the incidence rates of nosocomial infections caused by the multidrug-resistant P. aerugino- sa were 2. 6% and 1.4%, respectively; the difference in the incidence rate of nosocomial infections caused by ESBLs-producing E. coli or ESBLs-producing K. pneurnoniae was not significant. CONCLUSIONS The incidence of the nosocomial infections can be effectively reduced through the real-time monitoring of the patients being infected or colonized with MDROs, standard prevention measures, strict hand hygiene, as well as disinfection and isolation system.