摘要
目的:研究全程标准化防控ICU纤维支气管镜(纤支镜)相关多重耐药菌(Multidrug-Resistant Organism,MDRO)感染策略的效果。方法:采用历史对照研究,将2017年1-12月及2018年2月至2019年1月在我院ICU住院有人工气道且行纤支镜诊治患者分别设为对照组(n=322)和实验组(n=330)。对照组采用常规纤支镜操作及清洗消毒方法;实验组采用全程标准化防控纤支镜相关MDRO感染策略。比较两组患者纤支镜检查后第3日痰培养MDRO检出率及细菌分布、下呼吸道MDRO定植/感染率、备用纤支镜及全自动内镜清洗消毒机消毒液采样细菌培养结果及两组医护人员操作时手卫生及自身防护措施依从性、护士MDRO防控知识合格率的差异。结果:实验组MDRO检出率低于对照组,差异有统计学意义(P<0.001);对照组鲍曼不动杆菌(MDR/PDR-AB)检出率最多(3.94%),而实验组为0,差异有统计学意义(P<0.001);实验组患者MDRO感染率/定植率均低于对照组,有统计学意义(P<0.001);实验组操作时医护人员手卫生执行率、自身防护措施依从性、护士对纤支镜标准化清洗消毒流程及MDRO防控知识合格率高于对照组(P<0.05)。结论:全程标准化防控纤支镜相关MDRO感染策略,可降低纤支镜相关MDRO医院感染发生。
Objective: To explore the effect of standardized strategies for the prevention of ICU bronchoscope-associated Multidrug-Resistant Organism(MDRO) in the whole procedure. Methods: A historical control study was adopted. The patients with artificial airway who received bronchofiberscopy in our ICU were divided into 2 groups, control(from January to December 2017)(n=322) or intervention(from February 2018 to January 2019)(n=330) group. Routine bronchoscopy procedure and reprocessing methods were applied in the control group. While standardized strategies for prevention of ICU bronchofiberscopy-associated MDRO in the whole procedure were adopted the intervention group. The number of MDRO isolated from the sputum culture specimens on the 3 rd day after bronchocopy, and the colonization/infection rate of MDRO in lower respiratory tract were compared between the two groups. The compliance of hand hygiene and self-protection measures in healthcare professionals, qualified rate of the knowledge regarding the prevention of bronchocopy-related MDRO were compared between the two groups as well. Results: The total isolation rate of MDRO in the intervention group was significantly lower than that in the control group, χ2=99.326, P<0.001;Acinetobacter baumannii(MDR/PDR-AB) was found higher(3.94%) in the control group than the intervention group(0)(χ2=34.816, P<0.001). The infection/colonization rate in the intervention group was lower than the control group, χ2=19.556, P<0.001;χ2=61.566, P<0.001. The compliance of hand hygiene and self-protection measures of healthcare professionals, as well as the qualified rate of the knowledge of prevention bronchocopy-related MDRO in the intervention group were significantly higher than those in the control group(P<0.05). Conclusion: The standardized strategies for the prevention of ICU bronchofiberscopy-associated MDRO in the whole procedure can reduce the incidence of bronchoscope-related MDRO nosocomial infection.
作者
蒋玉兰
谌绍林
谢立琴
李思思
朱慷阔
JIANG Yulan;CHEN Shaolin;XIE Liqin;LI Sisi;ZHU Kangkuo(Intensive Care Unit,the First Affiliated Hospital of Hunan University of Medicine,Huaihua,418000,China)
出处
《中国护理管理》
CSCD
北大核心
2020年第11期1732-1736,共5页
Chinese Nursing Management
基金
湖南省卫生健康委员会科研课题(20200342)。
关键词
纤维支气管镜
多重耐药菌
医院感染
全程标准化防控
重症监护室
bronchoscopy
Multidrug-Resistant Organism
nosocomial infection
whole-procedure standardized prevention
Intensive Care Unit
