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目的通过采取手卫生促进活动,长期、持续地对急诊科多药耐药菌感染与定植进行干预,并通过日常监测了解多药耐药菌感染与定植流行趋势以验证干预效果。方法 2012年1-3月医院开展多药耐药菌感染与定植目标性监测;采取流行病学横断面研究的方法进行自身前后对照干预研究;应用IBM SPSS 21.0对数据进行整理和统计分析。结果 2012年1月-2014年3月急诊科住院患者发生多药耐药菌297例,检出最多的前3位多药耐药菌为耐甲氧西林金黄色葡萄球菌(MRSA)、多药耐药/泛耐药鲍氏不动杆菌(MDR/XDRAB)和耐碳青霉烯类大肠埃希菌(CRE);多药耐药菌感染与定植率由42.5%下降至19.8%(P<0.05);急诊科医务人员手卫生依从性从20.2%上升至49.3%(P<0.05)。结论通过在采取多药耐药菌医院感染预防控制干预措施,可有效降低多药耐药菌感染与定植率,从而阻断多药耐药菌的院内传播。
OBJECTIVE To intervene the infection and colonization of multidrug-resistant bacteria in the emergency department through the hand hygiene promotion activities in a long-term and continuous manner and to understand the prevalence of multi-drug resistant bacteria infection and colonization through daily monitoring to verify the intervention effect. Methods From January to March 2012, the hospital carried out targeted surveillance of multidrug-resistant bacterial infection and colonization. The epidemiological cross-sectional study was used to conduct self-control study before and after treatment. The data were sorted out and statistically analyzed with IBM SPSS 21.0. Results From January 2012 to March 2014, 297 multidrug-resistant bacteria occurred in emergency department inpatients. The top three multi-drug resistant bacteria were methicillin-resistant Staphylococcus aureus (MRSA), multi-drug Resistant / resistant Acinetobacter baumannii (MDR / XDRAB) and carbapenem-resistant Escherichia coli (CRE). The rates of multidrug-resistant bacterial infection and colonization decreased from 42.5% to 19.8% (P < 0.05). Hand hygiene compliance of emergency department staff increased from 20.2% to 49.3% (P <0.05). Conclusions The prevention and control of multidrug-resistant nosocomial infection can effectively reduce the infection rate and colonization rate of multidrug-resistant bacteria and thus prevent the multidrug-resistant bacteria from spreading in the hospital.