碘伏消除ESBL定植菌在预防下呼吸道感染中的可行性研究
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摘要
目的探讨碘伏消除ESBL定植菌在预防下呼吸道感染中的可行性。方法选择我院2013年3月~2014年12月入住神经外科的重症昏迷患者102例作为研究对象,随机分为观察组与对照组,各51例。对照组采取常规护理措施,观察组在采取常规护理措施的基础上同时采取碘伏处理鼻腔护理措施,比较两组患者的ESBL定植菌的发生率及下呼吸道感染的发生率。结果观察组中ESBL定植菌的发生率为19.31%,明显低于对照组的定植率41.18%,两组间差异有统计学意义(P<0.05)。同时观察组中发生下呼吸道感染的感染率为21.57%,明显低于对照组的感染发生率45.1%,两组间差异有统计学意义(P<0.05)。结论利用碘伏消除ESBL定植菌来预防下呼吸道感染的效果显著,操作简单,具有可行性,值得广泛推广运用。
Objective To explore the feasibility of iodophor eliminating extended spectrum βlactamase(ESBL) colonized bacteria in the prevention of lower respiratory infection. Methods 102 coma patients with severe diseases who were hospitalized in neurosurgery department in a hospital from to March 2013 to December 2014 were selected as the research objects and they were randomly divided into the observation group and the control group, with 51 in each.The control group was received routine nursing measures while observation group was received iodophor dealing with nasal cavity at the basis of routine nursing measures. Incidence of ESBL colonized bacteria and incidence of lower respiratory infection of patients in two groups were compared. Results The incidence of ESBL colonized bacteria of the observation group was 19.31%,significantly lower than that of the control group 41.18%.There was significant difference between two groups(P < 0.05).In addition,incidence of lower respiratory infection of the observation group was 21.57%, significantly lower than that of the control group 45.1%.There was significant difference between two groups(P < 0.05).And the difference was comparable and statistically significant. Conclusion Using iodophor to eliminating ESBL colonized bacteria in the prevention of lower respiratory infection has significant effect. It is feasible and easy to operate,worthy of wide promotion and application.
Objective To explore the feasibility of iodophor eliminating extended spectrum βlactamase(ESBL) colonized bacteria in the prevention of lower respiratory infection. Methods 102 coma patients with severe diseases who were hospitalized in neurosurgery department in a hospital from to March 2013 to December 2014 were selected as the research objects and they were randomly divided into the observation group and the control group, with 51 in each.The control group was received routine nursing measures while observation group was received iodophor dealing with nasal cavity at the basis of routine nursing measures. Incidence of ESBL colonized bacteria and incidence of lower respiratory infection of patients in two groups were compared. Results The incidence of ESBL colonized bacteria of the observation group was 19.31%,significantly lower than that of the control group 41.18%.There was significant difference between two groups(P < 0.05).In addition,incidence of lower respiratory infection of the observation group was 21.57%, significantly lower than that of the control group 45.1%.There was significant difference between two groups(P < 0.05).And the difference was comparable and statistically significant. Conclusion Using iodophor to eliminating ESBL colonized bacteria in the prevention of lower respiratory infection has significant effect. It is feasible and easy to operate,worthy of wide promotion and application.
引文
[1]郭魁,赵云龙,董全勇.神经外科重症昏迷病人肺部感染的防治[J].中国临床神经外科杂志,2013,18(1):42-44.
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[3]孙洪涛,王延民,魏正军,等.神经外科患者下呼吸道感染病原菌分布与耐药性分析[J].中华医院感染学杂志,2015,25(3):534-535.
[4]陈振华,刘文祥,吴安华,等.ICU多重耐药菌定植调查及耐药性分析[J].中国感染控制杂志,2010,9(3):155-159.
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[7]奚岳芬,张益峰,周勤伟,等.神经外科ICU患者医院感染目标监测分析及防治措施[J].基层医学论坛,2014,18(13):1719-1721.
[8]Apisarnthanarak A,Pinitchai U,Thongphubeth K,et a1.Amultifae eted intervention to reduce pandmg-resistant Acine tobacter baumannii colonization and infection in 3intensive care units in a Thai tertiary care center:a 3year study[J].Clin Infect Dis,2008,47(6):760-767.
[9]Hamihon-Miller JM.Vanomnyein-resistant Stalahyloceus anreus,A real and present danger?Infection,2002,30:118-124.
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[11]朱德妹,汪复,胡付品,等.2010年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2011,11(5):321-329.
[12]钟小仕,莫丹平,熊轩,等.莫匹罗星预防血透患者临时中心静脉导管相关感染的研究[J].广东医学,2011,32(10):1342-1344.
[13]刘晓白.顾剑,骆明波,等.三种消毒剂对ESBL阳性和阴性大肠杆菌杀灭效果的观察[J].中国消毒学杂志,2003,20(3):193-194.
[14]应庆茹,谈介凡,朱冬胜,等.多重耐药菌株(MRSA、ESBL)对2种常用消毒剂抗力的研究[J].中国公共卫生管理,2009,25(5):517-518.
[15]薛菊兰,艾彪,罗丽华.产超广谱β-内酰胺酶大肠埃希菌对常用消毒剂的敏感性观察[J].护理学杂志,2010,25(7):83-85.
[16]姜景卫,鲁华荣,周璐芳,等.术前口腔清洁干预对全麻插管后下呼吸道感染的影响[J].中国乡村医药杂志,2014,21(2):33-34.
[17]林宝丽,于美华,何丽云,等.鼻腔护理预防经鼻气管插管全麻术后下呼吸道感染的效果观察[J].护士进修杂志,2014,29(22):2084-2086.
[2]张贞.重症监护医院感染的预防和控制[J].中国现代药物应用,2015,9(20):288-289.
[3]孙洪涛,王延民,魏正军,等.神经外科患者下呼吸道感染病原菌分布与耐药性分析[J].中华医院感染学杂志,2015,25(3):534-535.
[4]陈振华,刘文祥,吴安华,等.ICU多重耐药菌定植调查及耐药性分析[J].中国感染控制杂志,2010,9(3):155-159.
[5]中华人民共和国卫生部.医院感染诊断标准(试行)[S].北京:中华人民共和国卫生部,2001.
[6]吴晓英,宋敏.神经外科气管切开患者下呼吸道感染监测与危险因素分析[J].现代预防医学,2015,42(10):1907-1909.
[7]奚岳芬,张益峰,周勤伟,等.神经外科ICU患者医院感染目标监测分析及防治措施[J].基层医学论坛,2014,18(13):1719-1721.
[8]Apisarnthanarak A,Pinitchai U,Thongphubeth K,et a1.Amultifae eted intervention to reduce pandmg-resistant Acine tobacter baumannii colonization and infection in 3intensive care units in a Thai tertiary care center:a 3year study[J].Clin Infect Dis,2008,47(6):760-767.
[9]Hamihon-Miller JM.Vanomnyein-resistant Stalahyloceus anreus,A real and present danger?Infection,2002,30:118-124.
[10]戴鹏飞,任静,梁艳.重症监护病房革兰阴性菌分布及其耐药性分析[J].武警医学,2014,25(12):1221-1224.
[11]朱德妹,汪复,胡付品,等.2010年中国CHINET细菌耐药性监测[J].中国感染与化疗杂志,2011,11(5):321-329.
[12]钟小仕,莫丹平,熊轩,等.莫匹罗星预防血透患者临时中心静脉导管相关感染的研究[J].广东医学,2011,32(10):1342-1344.
[13]刘晓白.顾剑,骆明波,等.三种消毒剂对ESBL阳性和阴性大肠杆菌杀灭效果的观察[J].中国消毒学杂志,2003,20(3):193-194.
[14]应庆茹,谈介凡,朱冬胜,等.多重耐药菌株(MRSA、ESBL)对2种常用消毒剂抗力的研究[J].中国公共卫生管理,2009,25(5):517-518.
[15]薛菊兰,艾彪,罗丽华.产超广谱β-内酰胺酶大肠埃希菌对常用消毒剂的敏感性观察[J].护理学杂志,2010,25(7):83-85.
[16]姜景卫,鲁华荣,周璐芳,等.术前口腔清洁干预对全麻插管后下呼吸道感染的影响[J].中国乡村医药杂志,2014,21(2):33-34.
[17]林宝丽,于美华,何丽云,等.鼻腔护理预防经鼻气管插管全麻术后下呼吸道感染的效果观察[J].护士进修杂志,2014,29(22):2084-2086.