环境清洁消毒方式的转变对ICU医院感染率的影响

Effect of environmental cleaning and disinfection on prevalence of nosocomial infection in ICU

目的探讨环境清洁消毒方式的改变对重症监护病房(ICU)医院感染率的影响,为探索预防和降低ICU医院感染发生率的方式提供参考。方法2016年1月1日-2016年10月31日和2017年1月1日-2017年10月31日入住黄石市中心医院ICU的患者分别做为原消毒方式组(含氯消毒剂擦拭)和新消毒方式组(一次性消毒纸擦拭),对比两组ICU卫生学采样合格率、感染率等相关指标。结果原消毒方式组与新消毒方式组之间ICU卫生学采样合格率为83.33%vs 98.61%(P<0.05),ICU感染率10.19%vs 3.38%(P<0.05)。呼吸机相关肺炎(VAP)感染发生率8.39‰vs 3.80‰(P<0.05),中央导管相关血流感染(CLABSI)发生率0.86‰vs 0‰,导尿管相关泌尿道感染(CAUTI)发生率1.24‰vs 1.26‰;多药耐药菌检出菌株中导致医院感染菌株构成比19.48%vs 7.95%。结论改进ICU清洁消毒的方式可提高清洁消毒的质量,并对预防和降低ICU整体的医院感染、呼吸机相关肺炎发生率及多药耐药菌检出菌株中导致医院感染菌株构成比有重要作用。

OBJECTIVE To explore the impact of environmental cleaning and disinfection on prevalence of nosocomial infection in intensive care unit(ICU)so as to provide guidance for prevention of the nosocomial infection in ICU.METHODS The patients who were hospitalized in the ICUs of Huangshi Central Hospital of Edong Healthcare Group from Jan 1,2016 to Oct 31,2016 and from Jan 1,2017 to Oct 31,2017 were enrolled in the study and divided into the original disinfection mode group(wiping with disinfectant containing chlorine)and the new disinfection mode group(wiping with disposable sterilizing wet wipe).The qualified rate of hygienic sampling and incidence of infections in the ICUs were observed and compared between the two groups.RESULTS The positive rate of hygienic sampling was 83.33%in the original disinfection mode group,98.61%in the new disinfection mode group(P<0.05);the incidence of infections in the ICU was 10.19%in the original disinfection mode group,3.38%in the new disinfection mode group(P<0.05).The incidence rate of ventilator-associated pneumonia(VAP)was 8.39‰in the original disinfection mode group,3.80‰in the new disinfection mode group(P<0.05);the incidence rate of central line associated-bloodstream infection(CLABSI)was 0.86‰in the original disinfection mode group,0‰in the new disinfection mode group;the incidence rate of catheter-associated urinary tract infection(CAUTI)was 1.20‰in the original disinfection mode group,1.24‰in the new disinfection mode group;the proportion of multidrug-resistant strains causing nosocomial infection was 19.48%in the original disinfection mode group,7.95%in the new disinfection mode group(P<0.05).CONCLUSION The improved cleaning and disinfection mode may raise the quality of cleaning and disinfection in the ICU,prevent and reduce the incidence of nosocomial infection and VAP as well as the proportion of multidrug-resistant strains causing the nosocomial infection.