综合干预措施降低医院感染耐甲氧西林金黄色葡萄球菌检出率效果评价

Effect of comprehensive intervention measures on reduction of isolation rate of methicillin-resistant Staphylococcus aureus causing nosocomial infection

目的分析某医院抗菌药物使用强度及医务人员手卫生依从性对医院感染MRSA检出率的影响,为临床合理用药和医院感染控制提供参考。方法收集2012-2013年医院住院患者抗菌药物使用强度、医务人员手卫生依从性及医院感染MRSA检出率,并统计其数理相关关系;数据录入EXCEL数据库后,采用SAS8.2统计软件进行统计。结果 2012-2013年住院患者抗菌药物及β-内酰胺类抗菌药物使用强度分别从78.2、49.2分别下降至39.4和22.8,医务人员手卫生依从率从约25.0%提高至>60.0%,医院感染MRSA检出率从55.2%持续下降至28.0%;医院感染病例中MRSA检出率与同期住院患者抗菌药物使用强度、β-内酰胺类抗菌药物使用强度有相关性,相关系数分别为0.724、0.784,相关关系差异有统计学意义。结论通过规范抗菌药物使用,落实多药耐药菌隔离措施特别是手卫生措施,积极开展细菌耐药性监测,能有效减少细菌耐药性的产生。

OBJECTIVE To observe the influence of the intensity of use of antibiotics and the hand hygiene compli- ance of medical staff on the isolation rate of MRSA from patients with nosocomial infections so as to provide guid- ance for reasonable clinical use of antibiotics and the control of nosocomial infections. METHODS From 2012 through 2013,the intensity of use of antibiotics of the hospitalized patients, the hand hygiene compliance of the medical staff, and the isolation rate of MRSA from the patients with nosocomial infections were collected, then the mathematical correlation between them was taken for statistics, the data were input to the EXCEL database, and the statistical analysis was performed with the use of SASS. 2 software. RESULTS From 2012 to 2013, the intensi- ty of use of antibiotics decreased from 78.2 to 39.4; the intensity of use of β-1actams decreased from 49.2 to 22.8. The hand hygiene compliance of the medical staff increased from about 25.0% to 60.0% or above. The isolation rate of MRSA causing nosocomial infection persistently dropped from 55.2 % to 28.0 %. There was correlation be- tween the isolation rate of MRSA from the cases of nosocomial infections and the intensity of use of antibiotics and the intensity of use of lactams, and the correlation coefficients were 0. 724 and 0. 784, with statistical significance. CONCLUSION It is an effective way to standardize the use of antibiotics, implement the isolation measures of mul- tidrug-resistant bacteria especially the hand hygiene measures, and actively conduct the surveillance of bacterial re- sistant so as to reduce the drug resistance rate.