多重耐药菌医院感染监测及效果评价

Monitoring and evaluation on healthcare-associated infection of multi drug-resistant organisms

目的了解PDCA循环法在多重耐药菌(MDROs)医院感染管理中的应用效果。方法回顾性分析2016-2017年医院发生MDROs感染患者的临床资料,并于2017年1月起运用PDCA循环法实施管理,对比干预前后MDROs医院感染情况。结果共分离出目标监测的MDROs 1 582株,其中医院感染的多重耐药菌166株,居前2位的是产ESBLs(+)大肠埃希菌(占42. 17%)和产ESBLs(+)肺炎克雷伯菌(占31. 33%);主要分布在ICU和神经外一病区;常见的感染部位为呼吸道和泌尿道;千日MDROs医院感染例次发生率由2016年的0. 30‰降至2017年0. 20‰。结论运用PDCA循环法可以降低MDROs医院感染风险。

Objective To understand the application of PDCA(Plan Do Check Action)cycle on multidrug-resistant organisms(MDROs)causing healthcare-associated infection(HAI).Methods From Jan 2016 to Dec 2017,the clinical data of MDROs-HAI were retrospectively analyzed.PDCA cycle was taken since Jan 2017,MDROs-HAI before and after intervention was compared.Results A total of 1 582 MDROs of target monitoring were isolated,of which 166 were MDROs-HAI,the top two MDROs were Escherichia coli(42.17%)and Klebsiella pneumoniae(31.33%),which both produced ESBLs.They were mainly distributed in the ICU and meural surgical.The main infection site of MDROs-HAI was respiratory tract,followed by urinary tract.The thousand day infectionrate of the MDROs-HAI decreased from 0.30‰in 2016 to 0.20‰in 2017.Conclusion The application of PDCA cycle can reduce the risk of MDROs-HAI.