某三甲医院多重耐药菌感染现状及集束干预效果

目的了解某三甲医院住院患者多重耐药菌(MDRO)感染现状,以及集束干预措施的防控效果。方法对2012—2014年该院发生MDRO感染的住院患者进行重点监测及集束干预。结果 2012—2014年共检出MDRO1 909株。2012—2014年MDRO检出率分别为30.69%、31.04%、29.40%,床旁干预率分别为81.02%、92.05%、94.23%,临床隔离落实率分别为69.97%、82.98%、93.04%;2012—2014年MDRO检出率比较,差异无统计学意义(P0.05);MDRO床旁干预率、临床隔离落实率比较,差异均具有统计学意义(均P0.05)。2012—2014年MDRO居前3位的分别为产超广谱β-内酰胺酶大肠埃希菌(ESBLs-EC)、多重耐药鲍曼不动杆菌(MDRAB)、产超广谱β-内酰胺酶肺炎克雷伯菌(ESBLs-KP)。结论通过多部门联动及强化现场督查等集束干预模式,促使MDRO医院感染管理更加规范,临床隔离落实率不断提高,有效预防和控制了MDRO在医院的传播。

Current situation of multidrug resistant organism infection and efficacy of bundle intervention measures in a tertiary first class hospital

ObjectiveTo understand the current situation of multidrug resistant organism (MDRO) infection in hospitalized patients in a tertiary first class hospital, as well as efficacy of bundle intervention measures on prevention and control of infection. MethodsHospitalized patients who were infected with MDROs in this hospital during 2012-2014 were monitored and conducted bundle intervention. ResultsIn 2012-2014, a total of 1 909 MDRO strains were isolated. The isolation rates of MDROs in 2012-2014 were 30.69%, 31.04%, and 29.40% respectively，bedside intervention rates were 81.02%, 92.05%, and 94.23% respectively，implementation rates of clinical isolation were 69.97%, 82.98%, and 93.04% respectively; MDRO isolation rates during 2012-2014 were not significantly different（P＞0.05）；bedside intervention rates and implementation rates of clinical isolation were both significantly different（both P＜0.05）. The top 3 isolated MDROs in 2012-2014 were extended spectrum β lactamases(ESBLs) producing Escherichia coli, multidrug resistant Acinetobacter baumannii, and ESBLs producing Klebsiella pneumoniae. ConclusionBundle intervention measures, such as multi department collaboration and strengthened on site supervision, can promote more standardized management of healthcare associated infection, enhance the implementation rate of clinical isolation, and effectively prevent and control the spread of MDRO in hospital.