内科ICU多重耐药菌目标性监测与干预效果的分析

Target Surveillance of Multidrug-resistant Bacteria in ICU of Internal Medicine and Analysis of Intervention Effect

目的探讨如何在内科ICU中进行目标性监测和采取干预措施降低感染率。方法在2017年1月至2018年12月期间我院收治的入住内科ICU的患者中选择40名患者,并将所选患者分成两组,观察组患者给予多重耐药菌目标性监测和干预措施,对照组患者不进行多重耐药菌目标性监测,详细分析患者多重耐药菌防御措施、两组之间多重耐药菌检出差异、组内耐药性病菌的构成情况、分布规律以及两组之间的多重耐药菌感染率差异。患者或患者家属对本研究知情同意。研究设置观察组与对照组,两组病例数对等,根据入选总例数进行平均分配,最终观察组与对照组各分配病例20例。观察组男11例,女9例,年龄24~61岁,平均(31.22±8.73)岁;对照组中男12例,女8例,年龄21~59岁,平均(30.43±8.68)岁。两组患者入院时均未检查多重耐药菌感染。两组患者ICU病房使用情况、病床使用情况、护理人员以及保洁人员均无变化。两组研究患者一般资料无明显区别,有可比性(P>0.05)。结果两组患者通过干预后,观察组隔离医嘱24 h下达率、医护人员相关防控知识知晓合格率、手卫生依从率均显著高于对照组;多重耐药菌感染率方面,观察组更低,差异有统计学意义;两组患者检出耐药菌构成情况比较无明显差异。结论内科ICU多重耐药菌目标性监测有助于提高相关细菌感染预防的科学性,能有效降低患者多重耐药菌感染率。

Objective To explore ways of targeted surveillance and interventions to reduce infection rates in internal ICU.Methods 40 of the patients admitted to the medical ICU in our hospital during January 2017-December 2018 were selected,and the selected patients were divided into two groups.The patients in the observation group were given target monitoring and intervention measures of multidrug-resistant bacteria,and the control group did not carry out target monitoring of multidrug-resistant bacteria.Differences.informed consent of the patient or the patient's family to this study.The study set up observation group and control group,the number of cases in the two groups was equal,according to the total number of selected cases were evenly distributed,and the fi nal observation group and control group each allocated 20 cases.The age of the observation group was 24-61 years,with an average(31.22±8.73)years;in the control group,12 men and 8 women,aged 21~59 years,with an average(30.43±8.68)years.MDRB infection was not examined on admission in both groups.Both groups had no change ICU ward usage,hospital bed usage,nursing staff and cleaning staff.There was no signifi cant difference in general data between the two groups(P>0.05).Results The rate of 24 hours of medical advice,the qualifi ed rate of knowledge of prevention and control and the compliance rate of hand hygiene in the observation group were signifi cantly higher than those in the control group.Conclusion Objective monitoring ICU multidrug resistant bacteria in internal medicine can improve the scientifi city of prevention of related bacterial infection and reduce the infection rate of multidrug resistant bacteria.