感染控制干预对医院多重耐药菌管理的效果观察
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摘要
目的观察感染控制干预(以下简称"感控干预")措施对全院多重耐药菌(Multidrug-Resistant Organism,MDRO感染的防控效果。方法运用目标性监测方法对某综合性医院2015-2017年住院患者的MDRO感染情况进行监测,以评价采取多部门协作式感控干预在多重耐药菌感染控制工作中是否有效,2015年为基线调查阶段(干预前),2016年为干预第1阶段,2017年为干预第2阶段,运用卡方检验对比分析每年各项指标的差异,从而分析该院感控干预措施是否有效。结果 2015、2016、2017年核心防控措施执行率各年度间差异有统计学意义(χ~2=52.28,P<0.05);干预后(2016、2017年)MDRO发病率低于干预前(2015年),且差异有统计学意义(χ~2=7.06,P<0.05);干预后(2017年)MDRO医院感染率低于干预前(2015年),且差异有统计学意义(χ~2=7.55,P<0.05);抗菌药物使用率各年度间差异有统计学意义(χ~2=6.47,P<0.05)。结论该院实行的感控干预措施对MDRO医院感染的防控有效。
Objective To examine the effects of infection control and intervention on the management of Multidrug-Resistant Organism(MDROs) in a hospital setting. Methods We used the method of target monitoring; this research retrospectively investigated the infection status of MDRO in a comprehensive hospital during 2015-2017 in order to evaluate the effectiveness of adopting collaborative strategy in MDRO infection control work. 2015 was the the baseline investigation stage(before intervention),2016 was the first phase of the infection control intervention and 2017 was the second phase of the infection control intervention. This research used chi-square test to compare MDRO related indicators among different years to examine whether the infection control interventions were effective. Results The implementation rate of core preventive and control measures in 2015,2016 and 2017 has significant difference among different yars(χ~2=52.28,P<0.05);The incidence of MDRO after intervention(2016,2017)was lower than that before intervention(2015),and the difference was statistically significant(χ~2=7.06, P<0.05); The nosocomial infection rate of MDRO after intervention(2017) was lower than that before intervention(2015), and the difference was statisticallysignficant(χ~2=7.55,P<0.05);There was significant difference in the usage rate of antibiotics among different years(χ~2=6.47, P<0.05). Conclusion The adopted infection control interventions are effective for preventing and controlling MDRO in hospital settings.
Objective To examine the effects of infection control and intervention on the management of Multidrug-Resistant Organism(MDROs) in a hospital setting. Methods We used the method of target monitoring; this research retrospectively investigated the infection status of MDRO in a comprehensive hospital during 2015-2017 in order to evaluate the effectiveness of adopting collaborative strategy in MDRO infection control work. 2015 was the the baseline investigation stage(before intervention),2016 was the first phase of the infection control intervention and 2017 was the second phase of the infection control intervention. This research used chi-square test to compare MDRO related indicators among different years to examine whether the infection control interventions were effective. Results The implementation rate of core preventive and control measures in 2015,2016 and 2017 has significant difference among different yars(χ~2=52.28,P<0.05);The incidence of MDRO after intervention(2016,2017)was lower than that before intervention(2015),and the difference was statistically significant(χ~2=7.06, P<0.05); The nosocomial infection rate of MDRO after intervention(2017) was lower than that before intervention(2015), and the difference was statisticallysignficant(χ~2=7.55,P<0.05);There was significant difference in the usage rate of antibiotics among different years(χ~2=6.47, P<0.05). Conclusion The adopted infection control interventions are effective for preventing and controlling MDRO in hospital settings.
引文
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[7]吴淑梅,黄小兰,任泽娟.集束化管理策略在多重耐药菌管理中的应用[J].中国感染控制杂志,2015,14(12):840-842.
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[9]Hidron AI,Edwards JR,Patel J,et al. NHSN annual up-date:antimicrobial-resistant pathogens associated with healthcare associated infections:annula summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007[J]. Infection Control Hospital Epidemiology,2008,29(11):996-1011.
[10]Tseng SH,Lee CM,Lin TY,et al. Emergence and spread of multi-drug resistant organisms:think globally and act locally[J]. Journal of Microbiology Immunology&Infection,2011,44(3):157-165.
[11]Siegel JD,Rhinehart E,Jackson M,et al. Management of multidrug-resistant organisms in health care settings, 2006.[J]. American Journal of Infection Control,2007,35(10):S165-S193.
[12]Gaynes R,Edwards JR. Overview of nosocomial infections caused by gram-negative bacilli[J].Clinical Infectious Diseases,2005,41(6):848-854.
[13]Klevens RM, Edwards JR, Tenover FC, et al.Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003[J]. Clinical Infectious Diseases An Official Publication of the Infectious Diseases Society of America,2006,42(3):389.
[14]System N. National Nosocomial Infections Surveillance(NNIS)System Report,data summary from January1992 through June 2003, issued August 2003.[J].American Journal of Infection Control,2003,31(8):481-498.
[15]贾会学,胡必杰,吴安华,等.多重耐药菌感染干预效果多中心研究[J].中国感染控制杂志,2015,14(8):524-529.
[16]陈萍,刘丁,方清永,等.住院患者多重耐药菌感染临床研究[J].中国微生态学杂志,2013,25(8):962-965.
[17]梁静,矫玲,宫庆月,等.落实防控措施降低多重耐药菌医院感染率[J].中国感染控制杂志,2015,14(2):114-116.
[18]李劲松,徐卫国.综合性医院合理缩短平均住院日的措施探讨[J].中国医院,2008,12(10):20-22.
[2]马士红.感控干预在多重耐药菌医院感染控制中的应用效果[J].中国当代医药,2016,23(3):134-136.
[3]杨会香.综合护理干预对控制ICU多重耐药菌感染的影响[J].护理管理杂志,2014,14(4):271-272.
[4]李红梅,吴焕卿,赵春霞,等.多部门联合干预模式在多重耐药菌医院感染防控中的作用[J].中国当代医药,2015(1):179-181.
[5]黄勋,邓子德,倪语星,等.多重耐药菌医院感染预防与控制中国专家共识[J].中国感染控制杂志,2015,14(1):1-9.
[6]中华人民共和国卫生部.多重耐药菌医院感染预防与控制技术指南(试行)[J].药物不良反应杂志,2011,13(2):108-109.
[7]吴淑梅,黄小兰,任泽娟.集束化管理策略在多重耐药菌管理中的应用[J].中国感染控制杂志,2015,14(12):840-842.
[8]张萌,张辉文.某三甲医院多重耐药菌感染现状及集束干预效果[J].中国感染控制杂志,2017,16(2):169-172.
[9]Hidron AI,Edwards JR,Patel J,et al. NHSN annual up-date:antimicrobial-resistant pathogens associated with healthcare associated infections:annula summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007[J]. Infection Control Hospital Epidemiology,2008,29(11):996-1011.
[10]Tseng SH,Lee CM,Lin TY,et al. Emergence and spread of multi-drug resistant organisms:think globally and act locally[J]. Journal of Microbiology Immunology&Infection,2011,44(3):157-165.
[11]Siegel JD,Rhinehart E,Jackson M,et al. Management of multidrug-resistant organisms in health care settings, 2006.[J]. American Journal of Infection Control,2007,35(10):S165-S193.
[12]Gaynes R,Edwards JR. Overview of nosocomial infections caused by gram-negative bacilli[J].Clinical Infectious Diseases,2005,41(6):848-854.
[13]Klevens RM, Edwards JR, Tenover FC, et al.Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003[J]. Clinical Infectious Diseases An Official Publication of the Infectious Diseases Society of America,2006,42(3):389.
[14]System N. National Nosocomial Infections Surveillance(NNIS)System Report,data summary from January1992 through June 2003, issued August 2003.[J].American Journal of Infection Control,2003,31(8):481-498.
[15]贾会学,胡必杰,吴安华,等.多重耐药菌感染干预效果多中心研究[J].中国感染控制杂志,2015,14(8):524-529.
[16]陈萍,刘丁,方清永,等.住院患者多重耐药菌感染临床研究[J].中国微生态学杂志,2013,25(8):962-965.
[17]梁静,矫玲,宫庆月,等.落实防控措施降低多重耐药菌医院感染率[J].中国感染控制杂志,2015,14(2):114-116.
[18]李劲松,徐卫国.综合性医院合理缩短平均住院日的措施探讨[J].中国医院,2008,12(10):20-22.