ICU分区管理对多重耐药菌感染的影响研究

Study on Influence of ICU Partition Management on Multidrug Resistant Organisms Infection

目的 探讨基于风险评估的分区管理方案在降低ICU患者MDROs感染发生率的应用与效果。方法 选取2017年8月—2018年9月的1848名患者为对照组,按常规隔离方法进行管理;选取2018年10月—2021年10月的5073名患者为观察组,按照风险评估标准将ICU感染患者转入疑似感染区和感染区进行诊疗、消毒隔离。结果 采用分区管理方案的观察组,医院感染例次发病率、多重耐药菌检出率、多重耐药菌医院感染例次发生率、耐碳青霉烯类肠杆菌科细菌、耐甲氧西林金黄色葡萄球菌和耐碳青霉烯类的肺炎克雷伯菌的感染发生率、停留ICU时长、住院费用、未愈率均低于对照组,差异有统计学意义(p﹤0.05),抗生素使用强度明显下降。结论 基于风险评估的分区管理方案可降低医院感染率和未愈率、减少停留ICU时长和住院费用等相关指标,但不能降低病死率。

Objective To explore the application and effect of a risk assessment-based partition management scheme in reducing the incidence of Multidrug-resistant Organisms(MDROs) infection in ICU patients. Methods A total of 1848 patients from August 2017 to September 2018 were selected as the control group, and managed according to conventional isolation methods;5073 patients from October 2018 to October 2021 were selected as the observation group, and infected patients in ICU were transferred to suspected infected areas and infected areas for diagnosis, treatment, disinfection and isolation according to risk assessment standards. Results The incidence of nosocomial infections, the detection rate of multiple drug resistant organisms, the incidence of nosocomial infections of multiple drug resistant organisms, the incidence of infection of carbapenem-resistant enterobacteriaceae, and the staphylococcus aureus, carbapenem-resistant klebsiella pneumoniae, length of stay in ICU, hospitalization costs, and not cured rate were all lower than those in the control group, with statistically significant differences(p< 0.05), and the intensity of antibiotic use was significantly reduced. Conclusion The partition management scheme based on risk assessment can reduce the hospital infection rate, not cured rate, the length of stay in ICU, hospitalization costs and other related indicators, but it cannot reduce the fatality rate.