重症监护病区CRE主动筛查及其效果评价

发布时间：2018-05-07 18:02

本文选题：主动筛查 + 耐碳青霉烯类肠杆菌科细菌　；参考：《中华医院感染学杂志》2017年18期

【摘要】：目的评价耐碳青霉烯类肠杆菌科细菌(CRE)主动筛查结合加强干预在重症监护病区(ICU)医院感染预防控制中的效果,为CRE医院感染预防与控制提供科学依据。方法以2016年6月1日-2017年4月30日入住ICU的患者为干预组,患者转入/入院时进行CRE主动筛查,选取2016年1月1日-2016年5月31日未开展CRE主动筛查的ICU住院患者作为对照组,对照组由临床医师根据患者病情进行细菌培养;两组患者均进行医院感染实时监测,CRE培养阳性者均采取接触隔离措施;采用χ~2检验比较主动筛查前后CRE医院感染率的变化。结果共监测2327例ICU住院患者(其中干预组1596例,对照组731例),干预期间CRE主动筛查率为68.23%(1089/1596),患者主动筛查CRE的定植率为4.22%(46/1089);以直肠的CRE定植率10.90%(41/376)最高,病原体以耐碳青霉烯类肺炎克雷伯菌(CRKP)最多,占84.78%(39/46);研究期间CRE医院感染率为0.99%(23/2327),医院感染病原体以CRKP为主,占86.96%(20/23);采取主动筛查干预措施后,干预组的CRE医院感染率(0.69%)显著低于对照组的CRE医院感染率1.64%。结论 CRE定植以CRKP为主,直肠中CRE定植率较高,采取主动筛查能够有效控制重症监护病区CRE医院感染的发生。
[Abstract]:Objective to evaluate the efficacy of active screening and intensive intervention in the prevention and control of nosocomial infection in severe care area (ICU), and to provide scientific basis for the prevention and control of CRE nosocomial infection. Methods the patients admitted to ICU from June 1, 2016 to April 30, 2017 were selected as the intervention group, the patients were selected for active CRE screening when they were transferred to or admitted to the hospital, and the hospitalized patients who did not carry out the CRE active screening between January 1, 2016 and May 31, 2016 were selected as the control group. The patients in the control group were cultured by clinicians according to the patient's condition; the patients in both groups were treated with contact isolation for real-time monitoring of nosocomial infection; 蠂 ~ 2 test was used to compare the changes of nosocomial infection rate of CRE before and after active screening. Results A total of 2327 ICU inpatients (1596 in the intervention group and 731 in the control group) were monitored. During the intervention period, the active screening rate of CRE was 68.23% 1089 / 1596, and the colonization rate of CRE was 4.2222 / 46 / 1089; the CRE colonization rate of the rectum was 10.90 / 376). The most common pathogens were Klebsiella carbapenicilli, accounting for 84.78 / 39 / 46. During the study period, the nosocomial infection rate of CRE was 0.9923 / 23270.The main pathogen of nosocomial infection was CRKP, accounting for 86.96% of 20 / 230.After taking active screening and intervention measures, The nosocomial infection rate of CRE in the intervention group (0.69%) was significantly lower than that in the control group (1.64%). Conclusion CRKP is the main colonization of CRE and the colonization rate of CRE in rectum is high. Active screening can effectively control the occurrence of CRE nosocomial infection in intensive care area.
【作者单位】：北京大学人民医院医院感染管理办公室;
【基金】：国家自然科学基金资助项目(81541139)
【分类号】：R446.5

【相似文献】