采用信息化技术实时标识与预警耐药菌

Real-time identification and early warning on drug-resistant bacteria by information technology

目的探讨通过信息化技术实时标识与预警耐药菌的方法,以便临床及时获取耐药菌信息。方法 2015年对HIS、LIS、医院感染监测三方系统接口进行改造,以HL7为接口框架设计标准、LIS为基准数据源以及HIS为患者信息库,在常用界面实现多方信息交互,对检出的耐药菌进行标识和预警,比较信息化前后耐药菌识别情况。结果通过信息化建设,信息化界面显示,耐药菌判定规则可以随意变动,数据结果更准确、及时。每日人工审核判定时间由30 min缩减至2 min,在任何内网计算机临床工作人员均可实时并方便地获得耐药菌信息。对耐药菌进行及时标识及干预后,2015—2017年医院感染控制重点科室耐药菌检出株数分别为284、289、309株,耐药菌床日获得率分别为9.23‰(284/30 773)、8.91‰(289/32 429)、8.34‰(309/37 031),耐药菌床日获得率略有下降。结论利用信息化技术,实时发现耐药菌,并对新发耐药菌进行及时标识与干预,有效降低耐药菌感染率。

Objective To explore the method of real-time identification and early warning of drug-resistant bacteria through information technology,timely obtain information about drug-resistant bacteria in clinic.Methods Interface of Hospital Information System(HIS),Laboratory Information Management System(LIS)and healthcare-associated infection(HAI)surveillance system were reconstructed in 2015,HL7 was used as interface framework to design standard,LIS was as baseline data source and HIS as patient information database,multi-information exchange was implemented on the commonly used interface,identification and early warning of detected drug-resistant bacteria was conducted,identification of drug-resistant bacteria before and after informationization was compared.Results Through the information construction,the information interface showed that the rules of drug-resistant bacteria determination can be changed at will,data results were more accurate and timely.The judgment time of manual review was reduced from 30 minutes to 2 minutes every day,information of drug-resistant bacteria can be obtained timely and conveniently on any internal network computer by clinical staff.After timely identification and intervention of drug-resistant bacteria,284,289 and 309 strains of drug-resistant bacteria were detected in key departments of HAI control in 2015-2017,drug-resistant bacteria per 1 000 bed-day were 9.23‰(284/30 773),8.91‰(289/32 429),and 8.34‰(309/37 031)respectively,with a slight decrease.Conclusion Through information technology,drug-resistant bacteria can be found timely,and new drug-resistant bacteria can be identified and intervened in time,so as to effectively reduce the infection rate of drug-resistant bacteria.