摘要
目的 探讨研究重症监护室(ICU)多重耐药菌感染患者的医院感染预防控制要点及护理措施。方法 于2019年5月—2020年5月在该院ICU收治的患者中随机抽出50例作观察对象,经尿液、痰液、血液、引流液等标本检测后,均确诊合并多重耐药菌感染,对其感染病症相关危险因素行回顾性分析,统计菌株构成以及感染部位分布情况,并探索出相关医院感染预防控制手段及护理措施,力求降低ICU患者多重耐药菌感染风险,提高其院内治疗安全。结果 50例患者中,除去性别差异以外,年龄≥60岁、ICU住院时间≥7 d、ICU病房一年内进入次数3次以上、导尿管留置时间≥7 d、抗生素种类3种以上、有创治疗等,是导致ICU患者诱发多重耐药菌感染的危险因素;50例患者多重耐药感染菌株构成比分别为铜绿假单胞菌(CRPA)48.00%(24/50),肺炎克雷伯菌(Kp)40.00%(20/50),耐甲氧西林金黄色葡萄球菌(MRSA)6.00%(3/50),鲍曼不动杆菌(CRAB)6.00%(3/50);多重耐药菌分布部位:泌尿系统18例,呼吸系统26例,血液6例,后采取对症处理后均可恢复健康生理环境,未见暴发性感染,经医生复查后均可痊愈出院。结论 ICU作为医院感染的高发科室,临床应根据多重耐药菌感染特点,对患者行相关诊疗护理操作时应有预见性地落实感染相关防控措施,包括加强医护人员相关知识及培训,严格执行无菌操作,做好环境卫生消毒及隔离措施,合理使用抗生素等,尤其是临床常见菌株及患者感染部位,需提前做好相关护理,是降低患者院内感染发生风险和提高医护人员工作质量的有效措施。
Objective To explore the key points and nursing measures of nosocomial infection prevention and control in patients with multidrug-resistant bacteria infection in the intensive care unit(ICU).Methods Fifty patients who were admitted to the ICU of the hospital from May 2019 to May 2020 were randomly selected for observation.After the urine,sputum,blood,drainage fluid and other samples were tested,all of them were diagnosed with multidrugresistant bacterial infection.A retrospective analysis was carried out on the risk factors related to their infectious diseases,the composition of bacterial strains and the distribution of infection sites were counted,and relevant nosocomial infection prevention and control measures and nursing measures were explored to reduce the risk of multidrugresistant bacteria infection in ICU patients and improve the safety of in-hospital treatment.Results Among the 50patients,except for gender differences,age ≥ 60 years,ICU length of stay ≥ 7 d,ICU admissions more than 3times within a year,catheter indwelling time ≥ 7 d,more than 3 types of antibiotics,invasive treatment are risk factor for multidrug-resistant infection in ICU patients;the composition ratios of multi-drug-resistant infections in 50patients were Pseudomonas aeruginosa(CRPA) 48.00%(24/50),Klebsiella pneumonia(Kp) 40.00%(20/50),methicillin-resistant golden yellow Staphylococcus(MRSA) 6.00%(3/50),Acinetobacter baumannii(CRAB) 6.00%(3/50);distribution sites of multidrug-resistant bacteria:18 cases of urinary system,26 cases of respiratory system,and 6cases of blood.After symptomatic treatment,all patients could recover to a healthy physiological environment,and no fulminant infection was found,and they were all cured and discharged after review by doctors.Conclusion ICU is a high-incidence department of nosocomial infection.According to the characteristics of multi-drug-resistant bacteria infection,infection-related prevention and control measures should be implemented predictably when performing relevant diagnosis and nursing operations on patients,including strengthening the knowledge and training of medical staff,and strictly implementing them.Aseptic operation,good environmental sanitation,disinfection and isolation measures,rational use of antibiotics,especially for common clinical strains and infected parts of patients,need to do relevant care in advance,these are to reduce the risk of nosocomial infection in patients and improve the quality of work of medical staff.
作者
方小林
FANG Xiaolin(Department of Infection Control,The Second Hospital of Nanping City,Nanping,Fujian Province,354200 China)
出处
《中外医疗》
2022年第15期147-152,共6页
China & Foreign Medical Treatment
关键词
ICU多重耐药菌感染
医院感染预防控制
护理
ICU multidrug-resistant bacterial infection
Nosocomial infection prevention and control
Nursing
