摘要
目的探讨多重耐药菌(MDROs)定植与ICU院感的相关性及其去定植干预对策。方法选择2017年1月-2019年3月某院ICU收治的重症患者172例作为观察对象,依据MDROs定植的检测结果分成未定植组92例、定植组80例,并将定植组患者依据随机数表法分成定植A组、定植B组,各40例。定植A组实施常规救治、隔离干预,定植B组中伴MDROs定植患者于常规救治情况下开展去定植干预,对比两组院感发生率。结果未定植组患者院感发生率(10.87%)低于定植组(23.75%),差异有统计学意义(P<0.05);定植B组患者院感发生率(12.50%)低于定植A组(35.00%),差异有统计学意义(P<0.05);去定植干预后定植B组患者中MDROs定植检出率低于定植A组,差异有统计学意义(P<0.05)。结论MDROs定植多见为产β-内酰胺酶细菌,且出现MDROs定植患者具有较高的院感发生危险性,而针对ICU重症患者,早期筛查MDROs,依据筛查结果开展高效去定植干预能降低院感风险。
Objective To explore the correlation between colonization of multi-drug resistant organisms(MDROs)and nosocomial infection of ICU and the intervention strategies for decolonization.Methods From January 2017 to March2019,172 cases of critically ill patients admitted to the ICU of our hospital were selected as the observation objects.According to the results of colonization of MDROs,they were divided into 92 cases of non-colonization group and 80 cases of colonization group.The patients in the colonization group were divided into colonization group A and colonization group B according to the random number table method,each group with 40 cases.The colonization group A carried out routine treatment and isolation intervention,and the patients with MDROs colonization in colonization group B carried out decolonization intervention under the routine treatment.The incidence of nosocomial infection between the two groups was compared.Results The incidence of nosocomial infection in the non-colonization group was(10.87%),lower than that in the colonization group(23.75%),and the difference was statistically significant(P<0.05).The incidence of nosocomial infection in the colonization group B was(12.50%),lower than that in the colonization group A(35.00%),and the difference was significant(P<0.05).After decolonization intervention,the detection rate of MDROs colonization in the colonization group B was lower than that in the colonization group A(P<0.05).Conclusion The colonization of MDROs was mostlyβ-lactamase-producing bacteria,and patients with MDROs colonization had a higher risk of nosocomial infection.For severely ill patients in ICU,early screening for MDROs and effective decolonization intervention based on screening results could reduce the risk of nosocomial infection.
作者
祝丽君
陈上仲
林晨
ZHU Li-jun;CHEN Shang-zhong;LIN Chen(Zhejiang Hospital,Hangzhou Zhejiang 310013,China)
出处
《中国消毒学杂志》
CAS
2020年第10期744-747,共4页
Chinese Journal of Disinfection
基金
浙江省医药卫生计划项目(2017KY181)。
关键词
多重耐药菌
定植
重症监护室
医院感染
干预对策
multi-drug resistant organisms
colonization
intensive care unit
nosocomial infection
intervention strategy
