新生儿病房多重耐药定植菌监测与护理管理对策

摘要:目的　掌握新生儿病室多重耐药菌定植情况，及时采取有效的管理措施，降低新生儿病室医院感染率。方法　收集2011年1月-12月新生儿病室住院病例708例，设为对照组，收集2012年1-12月住院病例1 299例，设为观察组。观察组在新生儿入院时常规采集咽拭子和痰标本，筛查多重耐药定植菌，对定植患儿及时采取接触隔离，同时加强医院感染的环节管理，比较两组新生儿医院感染的发生率。结果　新生儿医院感染率2011年与2012年比较，虽然2012年住院新生儿大幅增加，但医院感染率，感染例次率明显降低，差异有统计学意义。多重耐药菌定植分布，观察组1 299例，送检1 278例，送检率98%。检出多重耐药定植菌119株，以革兰阴性杆菌为主，肺炎克雷伯菌占51.2%，大肠埃希菌占41.1%，标本采集主要来源于咽拭子和痰标本。观察组和对照组定植菌感染发生率分别为7.5%和17.6%，两组比较χ2值为4.72，P＜0.05，差异有统计学意义。结论　新生儿病室常规进行多重耐药定植菌筛查，可以及时发现多重耐药菌定植患儿，早期接触隔离，加强医院感染的防控和护理管理，能够有效降低新生儿病室医院感染率。

Monitoring and nursing management of multidrug-resistant colonized bacteria countermeasure in neonatal ward

Abstract: Objective To know the multidrug-resistant colonized bacteria in neonatal ward, to take effective management measures in time, and to reduce the nosocomial infection rate in the neonatal ward. Methods 708 cases of hospitalized neonates treated in the neonatal ward from January 2011 to December 2011 were selected as the control group, while 1299 cases of hospitalized neonates treated from January 2012 to December 2012 were selected as the observation group. The throat swab and phlegm samples of the neonates in observation group were collected normally and the multidrug-resistant colonized bacteria were checked and screened. Contact isolation was timely implemented to the patients with colonized bacteria. Meanwhile, the management on the nosocomial infection was strengthened, and the rates of nosocomial infection were compared in the two groups. Results Although the quantity of the neonates increased largely from 2011 to 2012, the nosocomial infection rate and the case infection rate both reduced obviously, and the difference was of statistical significance. As for the distribution of multidrug-resistant colonized bacteria, 1278 out of the 1299 cases in the observation group were inspected and the inspection rate was 98%. 119 cases of multidrug-resistant colonized bacteria were detected, among which the gram-negative bacillus took the most, the klebsiella pneumoniae accounted for 51.2% and the escherichia coli accounted for 41.1%. The main sources of the samples were their throat swab and phlegm samples. The rates of the multidrug-resistant colonized bacteria in the observation group and the control group were respectively 7.5% and 17.6%. The χ2 value is 4.72 (P<0.05) and the difference was of statistical significance. Conclusion Regular inspection of multidrug-resistant colonized bacteria in the neonatal ward can help discover the neonates timely who are with multidrug-resistant colonized bacteria, and help conduct the contact isolation at the early stage. It is effective to reduce the nosocomial infection rate in the neonatal ward, if we strengthen control on nosocomial infection and the nursing management