摘要
目的研究重症监护病房单间隔离在防控多药耐药菌(MDROs)交叉感染中的作用,为做好多药耐药菌感染防控提供实践依据。方法采用回顾性调查研究方法,纳入2017年1-12月ICU收治的住院患者为研究对象,分析多药耐药菌感染患者的基本资料。将多药耐药菌感染患者分为单间组和非单间组,分析两组中多药耐药菌医院获得性(HA)和社区获得性(CA)患者感染例次率差异,以及多药耐药菌医院交叉感染例次率差异。结果多药耐药菌感染患者共76例,共检测到多药耐药菌(MDROs)112株,主要耐药菌株为耐碳青霉烯鲍氏不动杆菌(CRAB)70株(62.50%)。共发生感染87例次,主要感染部位为下呼吸道72例次(82.76%)。单间组与非单间组相比较,MDROs医院获得性及社区获得性感染例次率比较差异无统计学意义。CR-AB、CR-PA、CR-KP导致的医院交叉感染例次率比较差异无统计学意义。结论为减少重症监护病房多药耐药菌感染导致的交叉传播,应做好环境清洁消毒、手卫生、隔离防护、抗菌药物合理使用等综合性措施,而不能依赖于单一的单间隔离措施。
OBJECTIVE To observe the effect of single room isolation of intensive care unit on prevention and control of multidrug-resistant organisms（MDROs）cross-infection so as to provide guidance for prevention and control of the MDROs infection.METHODS By means of retrospective survey,the patients who were hospitalized the ICU from Jan 2017 to Dec 2017 were recruited as the study objects,the baseline data of the patients with MDROs infection were analyzed.The patients with MDROs infection were divided into the single room group and the nonsingle room group.The case-time infection rates of MDROs hospital-acquired infection and community-acquired infection,as well as the case-time infection rates of MDROs cross-infection were observed and compared between the two groups of patients.RESULTS A total of 112 strains of MDROs were isolated from 76 patients with MDROs infection,70（62.50%）of which were carbapenem-resistant Acinetobacter baumannii.Totally 87 case-times of patients had the infection,72（82.76%）of whom had lower respiratory tract infection.There were no significant differences in the case-time infection rates of MDROs hospital-acquired infection and community-acquired infection between the single room group and the non-single room group.There were no significant differences in the case-time infection rates of the cross-infection induced by CR-AB,CR-PA and CR-KP.CONCLUSION To reduce the cross spread of MDROs infection in the ICU,it is necessary to strengthen the environmental cleaning and disinfection,hand hygiene and isolation protection and reasonably use antibiotics,instead of only relying on the single room isolation.
作者
张甜嘉
赵峥嵘
张卫红
张永祥
刘波
ZHANG Tian-jia;ZHAO Zheng-rong;ZHANG Wei-hong;ZHANG Yong-xiang;LIU Bo(Tongzhou District Hospital of Traditional Chinese Medicine,Nantong,Jiangsu 226300,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第20期3171-3174,共4页
Chinese Journal of Nosocomiology
基金
江苏高校优势学科建设工程基金资助项目(JX10231802)
关键词
多药耐药菌
重症监护病房
单间隔离
交叉感染
Multidrug-resistant organism
Intensive care unit
Single room isolation
Cross-infection
