Risk factors and prevention and control strategies for hospital-acquired multidrug-resistant bacterial infections in intensive care unit patients_West China Medical Journal

Authors：

SHEN Wanzhu ¹ , CHENG Jun ² ,  YIN Jun ^1,2

1. Department of Infection Control, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230001, P. R. China;
2. Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230001, P. R. China;

Corresponding?author：

YIN Jun, Email: dongdanfu@163.com

Keywords：

Intensive care unit; multidrug-resistant bacteria; hospital-acquired infection

DOI：

10.7507/1002-0179.202502018

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Multidrug-resistant bacterial infection is one of the important causes of death in intensive care unit (ICU) patients, which can significantly increase the length of hospital stay and treatment costs for ICU patients. At present, domestic scholars have paid less attention to hospital-acquired multidrug-resistant bacterial infection in ICU patients. This article summarizes the clinical manifestations, risk factors, and prevention and control measures of hospital-acquired multidrug-resistant bacterial infection in ICU patients, aiming to improve the understanding of medical staff on the situation of hospital-acquired multidrug-resistant bacterial infection in ICU and promote the development of hospital infection prevention and control.

Citation： SHEN Wanzhu, CHENG Jun, YIN Jun. Risk factors and prevention and control strategies for hospital-acquired multidrug-resistant bacterial infections in intensive care unit patients. West China Medical Journal, 2025, 40(3): 348-353. doi: 10.7507/1002-0179.202502018 Copy

1.	Nelson RE, Hyun D, Jezek A, et al. Mortality, length of stay, and healthcare costs associated with multidrug-resistant bacterial infections among elderly hospitalized patients in the United States. Clin Infect Dis, 2022, 74(6): 1070-1080.
2.	Barrasa-Villar JI, Aibar-Remón C, Prieto-Andrés P, et al. Impact on morbidity, mortality, and length of stay of hospital-acquired infections by resistant microorganisms. Clin Infect Dis, 2017, 65(4): 644-652.
3.	Wp SE, Norhidayah M, Ar MNA. Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022. BMC Infect Dis, 2025, 25(1): 60.
4.	Pendleton JN, Gorman SP, Gilmore BF. Clinical relevance of the ESKAPE pathogens. Expert Rev Anti Infect Ther, 2013, 11(3): 297-308.
5.	田華. 多重耐藥菌臨床分布特點研究. 中國繼續醫學教育, 2021, 13(17): 142-145.
6.	孫桂英, 倪曉艷, 方國蘭, 等. 三級綜合醫院常見多重耐藥菌醫院感染的臨床特點及耐藥性分析. 臨床合理用藥, 2024, 17(34): 189-192, 封 3.
7.	劉超梅, 閆曉芳, 宿瑞俊, 等. 臨床常見多重耐藥菌分布特點及耐藥性. 中國國境衛生檢疫雜志, 2024, 47(1): 92-95.
8.	Loe MWC, Yeo KT. Early-life surface colonization with multi-drug resistant organisms in the neonatal intensive care unit. Int J Infect Dis, 2023, 136: 11-13.
9.	Ramirez CB, Cantey JB. Antibiotic resistance in the neonatal intensive care unit. Neoreviews, 2019, 20(3): e135-e144.
10.	Flannery DD, Chiotos K, Gerber JS, et al. Neonatal multidrug-resistant gram-negative infection: epidemiology, mechanisms of resistance, and management. Pediatr Res, 2022, 91(2): 380-391.
11.	De Rose DU, Pugnaloni F, Martini L, et al. Staphylococcal infections and neonatal skin: data from literature and suggestions for the clinical management from four challenging patients. Antibiotics (Basel), 2023, 12(4): 632.
12.	Rallis D, Giapros V, Serbis A, et al. Fighting antimicrobial resistance in neonatal intensive care units: rational use of antibiotics in neonatal sepsis. Antibiotics (Basel), 2023, 12(3): 508.
13.	劉敬, 馮星, 胡才寶, 等. 新生兒肺臟疾病超聲診斷指南. 中國當代兒科雜志, 2019, 21(2): 105-113.
14.	馬雪玲, 史源, 蔡金華, 等. 新生兒顱腦磁共振檢查臨床實踐的專家共識. 中國當代兒科雜志, 2022, 24(1): 14-25.
15.	何云雁, 陳鳳, 張鈺, 等. C 反應蛋白指導下的新生兒疑診早發型敗血癥抗生素治療策略. 中國當代兒科雜志, 2020, 22(1): 12-16.
16.	Brown JVE, Meader N, Cleminson J, et al. C-reactive protein for diagnosing late-onset infection in newborn infants. Cochrane Database Syst Rev, 2019, 1(1): CD012126.
17.	Minotti C, Barbieri E, Giaquinto C, et al. Vancomycin use in children and neonates across three decades: a bibliometric analysis of the top-cited articles. Pathogens, 2021, 10(10): 1343.
18.	Wang Z, Xia Z. What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study. Ital J Pediatr, 2020, 46(1): 17.
19.	黃蘭清, 陳清秀, 蔡榕, 等. 兒童重癥監護室多重耐藥菌感染情況及危險因素. 中華醫院感染學雜志, 2020, 30(9): 1436-1440.
20.	蒲定紅, 余漪漪, 孫慧. 兒童重癥監護室住院患兒多重耐藥菌感染的特點及危險因素. 貴州醫科大學學報, 2024, 49(4): 589-595, 602.
21.	朱永冰, 付麗娜, 陳中舉, 等. 新冠疫情前后 PICU 細菌變遷及耐藥性變化研究. 華中科技大學學報(醫學版), 2023, 52(2): 233-238.
22.	Tamma PD, Aitken SL, Bonomo RA, et al. Infectious diseases society of america guidance on the treatment of extended-spectrum β-lactamase producing Enterobacterales (ESBL-E), carbapenem-resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with difficult-to-treat resistance (DTR-P. aeruginosa). Clin Infect Dis, 2021, 72(7): e169-e183.
23.	Póvoa P, Coelho L, Almeida E, et al. C-reactive protein as a marker of infection in critically ill patients. Clin Microbiol Infect, 2005, 11(2): 101-108.
24.	Golli AL, Cristea OM, Zlatian O, et al. Prevalence of multidrug-resistant pathogens causing bloodstream infections in an intensive care unit. Infect Drug Resist, 2022, 15: 5981-5992.
25.	Al-Sunaidar KA, Aziz NA, Hassan Y, et al. Association of multidrug resistance bacteria and clinical outcomes of adult patients with sepsis in the intensive care unit. Trop Med Infect Dis, 2022, 7(11): 365.
26.	Haddadin Y, Annamaraju P, Regunath H. Central line-associated blood stream infections. Treasure Island: StatPearls, 2022.
27.	Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis, 2009, 49(1): 1-45.
28.	Inchingolo R, Pierandrei C, Montemurro G, et al. Antimicrobial resistance in common respiratory pathogens of chronic bronchiectasis patients: a literature review. Antibiotics (Basel), 2021, 10(3): 326.
29.	Fan N, Hu Y, Shen H, et al. Compositional and drug-resistance profiling of pathogens in patients with severe acute pancreatitis: a retrospective study. BMC Gastroenterol, 2020, 20(1): 405.
30.	Sartelli M, Tascini C, Coccolini F, et al. Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use. World J Emerg Surg, 2024, 19(1): 23.
31.	Hall CW, Mah TF. Molecular mechanisms of biofilm-based antibiotic resistance and tolerance in pathogenic bacteria. FEMS Microbiol Rev, 2017, 41(3): 276-301.
32.	Vincent JL, Marshall JC, Namendys-Silva SA, et al. Assessment of the worldwide burden of critical illness: the intensive care over nations (ICON) audit. Lancet Respir Med, 2014, 2(5): 380-386.
33.	Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
34.	Sung K, Park M, Kweon O, et al. Proteomic insights into dual-species biofilm formation of E. coli and E. faecalis on urinary catheters. Sci Rep, 2025, 15(1): 3739.
35.	Ezzariga N, Zouhari O, Rhars A, et al. Biofilm and antibiotic resistance study of bacteria involved in nosocomial infections. Cureus, 2025, 17(2): e78673.
36.	Rodríguez-Villodres á, Martín-Gandul C, Pe?alva G, et al. Prevalence and risk factors for multidrug-resistant organisms colonization in long-term care facilities around the world: a review. Antibiotics (Basel), 2021, 10(6): 680.
37.	Wu C, Lu J, Ruan L, et al. Tracking epidemiological characteristics and risk factors of multi-drug resistant bacteria in intensive care units. Infect Drug Resist, 2023, 16: 1499-1509.
38.	Hota B. Contamination, disinfection, and cross-colonization: are hospital surfaces reservoirs for nosocomial infection?. Clin Infect Dis, 2004, 39(8): 1182-1189.
39.	Vincent JL, Rello J, Marshall J, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA, 2009, 302(21): 2323-2329.
40.	Jensen JU, Hein L, Lundgren B, et al. Invasive candida infections and the harm from antibacterial drugs in critically ill patients: data from a randomized, controlled trial to determine the role of ciprofloxacin, piperacillin-tazobactam, meropenem, and cefuroxime. Crit Care Med, 2015, 43(3): 594-602.
41.	Prechter F, Katzer K, Bauer M, et al. Sleeping with the enemy: clostridium difficile infection in the intensive care unit. Crit Care, 2017, 21(1): 260.
42.	Armand-Lefèvre L, Angebault C, Barbier F, et al. Emergence of imipenem-resistant gram-negative bacilli in intestinal flora of intensive care patients. Antimicrob Agents Chemother, 2013, 57(3): 1488-1495.
43.	?zger HS, Fak?o?lu DM, Erbay K, et al. Inapropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study. BMC Infect Dis, 2020, 20(1): 289.
44.	Macera M, Calò F, Onorato L, et al. Inappropriateness of antibiotic prescribing in medical, surgical and intensive care units: results of a multicentre observational study. Life (Basel), 2021, 11(6): 475.
45.	Melnyk AH, Wong A, Kassen R. The fitness costs of antibiotic resistance mutations. Evol Appl, 2015, 8(3): 273-283.
46.	何禮賢. 限制抗菌藥物使用對降低耐藥率作用的爭議: 解讀與思考. 中華醫學雜志, 2022, 102(20): 1487-1491.
47.	彭雅蘭, 林吉, 黃文治, 等. 過氧化氫發生器對多重耐藥菌消毒效果的 meta 分析. 華西醫學, 2021, 36(3): 341-347.
48.	Doll M, Morgan DJ, Anderson D, et al. Touchless technologies for decontamination in the hospital: a review of hydrogen peroxide and UV devices. Curr Infect Dis Rep, 2015, 17(9): 498.
49.	Deshpande A, Dunn AN, Fox J, et al. Monitoring the effectiveness of daily cleaning practices in an intensive care unit (ICU) setting using an adenosine triphosphate (ATP) bioluminescence assay. Am J Infect Control, 2020, 48(7): 757-760.
50.	何莉, 呂宇, 徐麗萍, 等. 各種干預措施對基層綜合醫院多重耐藥菌控制效果研究. 華西醫學, 2017, 32(3): 329-333.
51.	鐘曉, 肖麗華, 吳慶飛, 等. 比較三種檢測方法在檢測醫院高頻接觸物體表面清潔消毒效果的作用和成本效果. 熱帶醫學雜志, 2018, 18(1): 32-35.
52.	Feng Y, Wei L, Zhu S, et al. Handwashing sinks as the source of transmission of ST16 carbapenem-resistant Klebsiella pneumoniae, an international high-risk clone, in an intensive care unit. J Hosp Infect, 2020, 104(4): 492-496.
53.	Kizny Gordon AE, Mathers AJ, Cheong EYL, et al. The hospital water environment as a reservoir for carbapenem-resistant organisms causing hospital-acquired infections-a systematic review of the literature. Clin Infect Dis, 2017, 64(10): 1435-1444.
54.	Low JM, Chan M, Low JL, et al. The impact of sink removal and other water-free interventions in intensive care units on water-borne healthcare-associated infections: a systematic review. J Hosp Infect, 2024, 150: 61-71.
55.	喬甫, 衛麗, 莊紅娣, 等. 含氯己定醇的速干手消毒劑對常見多重耐藥菌殺滅效果研究. 華西醫學, 2017, 32(3): 375-376.
56.	Fan CY, Lee WT, Hsu TC, et al. Effect of chlorhexidine bathing on colonization or infection with Acinetobacter baumannii: a systematic review and meta-analysis. J Hosp Infect, 2019, 103(3): 284-292.
57.	Septimus EJ, Schweizer ML. Decolonization in prevention of health care-associated infections. Clin Microbiol Rev, 2016, 29(2): 201-222.
58.	Worldwide Antimicrobial Resistance National/International Network Group (WARNING) Collaborators. Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action. World J Emerg Surg, 2023, 18(1): 50.
59.	Levy Hara G, Rojas-Cortés R, Molina León HF, et al. Point prevalence survey of antibiotic use in hospitals in Latin American countries. J Antimicrob Chemother, 2022, 77(3): 807-815.
60.	Calderwood MS, Anderson DJ, Bratzler DW, et al. Strategies to prevent surgical site infections in acute-care hospitals: 2022 update. Infect Control Hosp Epidemiol, 2023, 44(5): 695-720.
61.	Khilnani GC, Zirpe K, Hadda V, et al. Guidelines for antibiotic prescription in intensive care unit. Indian J Crit Care Med, 2019, 23(Suppl 1): S1-S63.
62.	Khilnani GC, Tiwari P, Mittal S, et al. Guidelines for antibiotics prescription in critically ill patients. Indian J Crit Care Med, 2024, 28(Suppl 2): S104-S216.
63.	Niederman MS. Adjunctive nebulized antibiotics: what is their place in ICU infections?. Front Med (Lausanne), 2019, 6: 99.
64.	Martinez EP, Cepeda M, Jovanoska M, et al. Seasonality of antimicrobial resistance rates in respiratory bacteria: a systematic review and meta-analysis. PLoS One, 2019, 14(8): e0221133.
65.	Cave R, Cole J, Mkrtchyan HV. Surveillance and prevalence of antimicrobial resistant bacteria from public settings within urban built environments: challenges and opportunities for hygiene and infection control. Environ Int, 2021, 157: 106836.
66.	楊啟文, 吳安華, 胡必杰, 等. 臨床重要耐藥菌感染傳播防控策略專家共識. 中國感染控制雜志, 2021, 20(1): 1-14.

1. Nelson RE, Hyun D, Jezek A, et al. Mortality, length of stay, and healthcare costs associated with multidrug-resistant bacterial infections among elderly hospitalized patients in the United States. Clin Infect Dis, 2022, 74(6): 1070-1080.
2. Barrasa-Villar JI, Aibar-Remón C, Prieto-Andrés P, et al. Impact on morbidity, mortality, and length of stay of hospital-acquired infections by resistant microorganisms. Clin Infect Dis, 2017, 65(4): 644-652.
3. Wp SE, Norhidayah M, Ar MNA. Factors associated with multidrug-resistant organism (MDRO) mortality: an analysis from the national surveillance of multidrug-resistant organism, 2018-2022. BMC Infect Dis, 2025, 25(1): 60.
4. Pendleton JN, Gorman SP, Gilmore BF. Clinical relevance of the ESKAPE pathogens. Expert Rev Anti Infect Ther, 2013, 11(3): 297-308.
5. 田華. 多重耐藥菌臨床分布特點研究. 中國繼續醫學教育, 2021, 13(17): 142-145.
6. 孫桂英, 倪曉艷, 方國蘭, 等. 三級綜合醫院常見多重耐藥菌醫院感染的臨床特點及耐藥性分析. 臨床合理用藥, 2024, 17(34): 189-192, 封 3.
7. 劉超梅, 閆曉芳, 宿瑞俊, 等. 臨床常見多重耐藥菌分布特點及耐藥性. 中國國境衛生檢疫雜志, 2024, 47(1): 92-95.
8. Loe MWC, Yeo KT. Early-life surface colonization with multi-drug resistant organisms in the neonatal intensive care unit. Int J Infect Dis, 2023, 136: 11-13.
9. Ramirez CB, Cantey JB. Antibiotic resistance in the neonatal intensive care unit. Neoreviews, 2019, 20(3): e135-e144.
10. Flannery DD, Chiotos K, Gerber JS, et al. Neonatal multidrug-resistant gram-negative infection: epidemiology, mechanisms of resistance, and management. Pediatr Res, 2022, 91(2): 380-391.
11. De Rose DU, Pugnaloni F, Martini L, et al. Staphylococcal infections and neonatal skin: data from literature and suggestions for the clinical management from four challenging patients. Antibiotics (Basel), 2023, 12(4): 632.
12. Rallis D, Giapros V, Serbis A, et al. Fighting antimicrobial resistance in neonatal intensive care units: rational use of antibiotics in neonatal sepsis. Antibiotics (Basel), 2023, 12(3): 508.
13. 劉敬, 馮星, 胡才寶, 等. 新生兒肺臟疾病超聲診斷指南. 中國當代兒科雜志, 2019, 21(2): 105-113.
14. 馬雪玲, 史源, 蔡金華, 等. 新生兒顱腦磁共振檢查臨床實踐的專家共識. 中國當代兒科雜志, 2022, 24(1): 14-25.
15. 何云雁, 陳鳳, 張鈺, 等. C 反應蛋白指導下的新生兒疑診早發型敗血癥抗生素治療策略. 中國當代兒科雜志, 2020, 22(1): 12-16.
16. Brown JVE, Meader N, Cleminson J, et al. C-reactive protein for diagnosing late-onset infection in newborn infants. Cochrane Database Syst Rev, 2019, 1(1): CD012126.
17. Minotti C, Barbieri E, Giaquinto C, et al. Vancomycin use in children and neonates across three decades: a bibliometric analysis of the top-cited articles. Pathogens, 2021, 10(10): 1343.
18. Wang Z, Xia Z. What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study. Ital J Pediatr, 2020, 46(1): 17.
19. 黃蘭清, 陳清秀, 蔡榕, 等. 兒童重癥監護室多重耐藥菌感染情況及危險因素. 中華醫院感染學雜志, 2020, 30(9): 1436-1440.
20. 蒲定紅, 余漪漪, 孫慧. 兒童重癥監護室住院患兒多重耐藥菌感染的特點及危險因素. 貴州醫科大學學報, 2024, 49(4): 589-595, 602.
21. 朱永冰, 付麗娜, 陳中舉, 等. 新冠疫情前后 PICU 細菌變遷及耐藥性變化研究. 華中科技大學學報(醫學版), 2023, 52(2): 233-238.
22. Tamma PD, Aitken SL, Bonomo RA, et al. Infectious diseases society of america guidance on the treatment of extended-spectrum β-lactamase producing Enterobacterales (ESBL-E), carbapenem-resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with difficult-to-treat resistance (DTR-P. aeruginosa). Clin Infect Dis, 2021, 72(7): e169-e183.
23. Póvoa P, Coelho L, Almeida E, et al. C-reactive protein as a marker of infection in critically ill patients. Clin Microbiol Infect, 2005, 11(2): 101-108.
24. Golli AL, Cristea OM, Zlatian O, et al. Prevalence of multidrug-resistant pathogens causing bloodstream infections in an intensive care unit. Infect Drug Resist, 2022, 15: 5981-5992.
25. Al-Sunaidar KA, Aziz NA, Hassan Y, et al. Association of multidrug resistance bacteria and clinical outcomes of adult patients with sepsis in the intensive care unit. Trop Med Infect Dis, 2022, 7(11): 365.
26. Haddadin Y, Annamaraju P, Regunath H. Central line-associated blood stream infections. Treasure Island: StatPearls, 2022.
27. Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis, 2009, 49(1): 1-45.
28. Inchingolo R, Pierandrei C, Montemurro G, et al. Antimicrobial resistance in common respiratory pathogens of chronic bronchiectasis patients: a literature review. Antibiotics (Basel), 2021, 10(3): 326.
29. Fan N, Hu Y, Shen H, et al. Compositional and drug-resistance profiling of pathogens in patients with severe acute pancreatitis: a retrospective study. BMC Gastroenterol, 2020, 20(1): 405.
30. Sartelli M, Tascini C, Coccolini F, et al. Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use. World J Emerg Surg, 2024, 19(1): 23.
31. Hall CW, Mah TF. Molecular mechanisms of biofilm-based antibiotic resistance and tolerance in pathogenic bacteria. FEMS Microbiol Rev, 2017, 41(3): 276-301.
32. Vincent JL, Marshall JC, Namendys-Silva SA, et al. Assessment of the worldwide burden of critical illness: the intensive care over nations (ICON) audit. Lancet Respir Med, 2014, 2(5): 380-386.
33. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019, 38(1): 48-79.
34. Sung K, Park M, Kweon O, et al. Proteomic insights into dual-species biofilm formation of E. coli and E. faecalis on urinary catheters. Sci Rep, 2025, 15(1): 3739.
35. Ezzariga N, Zouhari O, Rhars A, et al. Biofilm and antibiotic resistance study of bacteria involved in nosocomial infections. Cureus, 2025, 17(2): e78673.
36. Rodríguez-Villodres á, Martín-Gandul C, Pe?alva G, et al. Prevalence and risk factors for multidrug-resistant organisms colonization in long-term care facilities around the world: a review. Antibiotics (Basel), 2021, 10(6): 680.
37. Wu C, Lu J, Ruan L, et al. Tracking epidemiological characteristics and risk factors of multi-drug resistant bacteria in intensive care units. Infect Drug Resist, 2023, 16: 1499-1509.
38. Hota B. Contamination, disinfection, and cross-colonization: are hospital surfaces reservoirs for nosocomial infection?. Clin Infect Dis, 2004, 39(8): 1182-1189.
39. Vincent JL, Rello J, Marshall J, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA, 2009, 302(21): 2323-2329.
40. Jensen JU, Hein L, Lundgren B, et al. Invasive candida infections and the harm from antibacterial drugs in critically ill patients: data from a randomized, controlled trial to determine the role of ciprofloxacin, piperacillin-tazobactam, meropenem, and cefuroxime. Crit Care Med, 2015, 43(3): 594-602.
41. Prechter F, Katzer K, Bauer M, et al. Sleeping with the enemy: clostridium difficile infection in the intensive care unit. Crit Care, 2017, 21(1): 260.
42. Armand-Lefèvre L, Angebault C, Barbier F, et al. Emergence of imipenem-resistant gram-negative bacilli in intestinal flora of intensive care patients. Antimicrob Agents Chemother, 2013, 57(3): 1488-1495.
43. ?zger HS, Fak?o?lu DM, Erbay K, et al. Inapropriate use of antibiotics effective against gram positive microorganisms despite restrictive antibiotic policies in ICUs: a prospective observational study. BMC Infect Dis, 2020, 20(1): 289.
44. Macera M, Calò F, Onorato L, et al. Inappropriateness of antibiotic prescribing in medical, surgical and intensive care units: results of a multicentre observational study. Life (Basel), 2021, 11(6): 475.
45. Melnyk AH, Wong A, Kassen R. The fitness costs of antibiotic resistance mutations. Evol Appl, 2015, 8(3): 273-283.
46. 何禮賢. 限制抗菌藥物使用對降低耐藥率作用的爭議: 解讀與思考. 中華醫學雜志, 2022, 102(20): 1487-1491.
47. 彭雅蘭, 林吉, 黃文治, 等. 過氧化氫發生器對多重耐藥菌消毒效果的 meta 分析. 華西醫學, 2021, 36(3): 341-347.
48. Doll M, Morgan DJ, Anderson D, et al. Touchless technologies for decontamination in the hospital: a review of hydrogen peroxide and UV devices. Curr Infect Dis Rep, 2015, 17(9): 498.
49. Deshpande A, Dunn AN, Fox J, et al. Monitoring the effectiveness of daily cleaning practices in an intensive care unit (ICU) setting using an adenosine triphosphate (ATP) bioluminescence assay. Am J Infect Control, 2020, 48(7): 757-760.
50. 何莉, 呂宇, 徐麗萍, 等. 各種干預措施對基層綜合醫院多重耐藥菌控制效果研究. 華西醫學, 2017, 32(3): 329-333.
51. 鐘曉, 肖麗華, 吳慶飛, 等. 比較三種檢測方法在檢測醫院高頻接觸物體表面清潔消毒效果的作用和成本效果. 熱帶醫學雜志, 2018, 18(1): 32-35.
52. Feng Y, Wei L, Zhu S, et al. Handwashing sinks as the source of transmission of ST16 carbapenem-resistant Klebsiella pneumoniae, an international high-risk clone, in an intensive care unit. J Hosp Infect, 2020, 104(4): 492-496.
53. Kizny Gordon AE, Mathers AJ, Cheong EYL, et al. The hospital water environment as a reservoir for carbapenem-resistant organisms causing hospital-acquired infections-a systematic review of the literature. Clin Infect Dis, 2017, 64(10): 1435-1444.
54. Low JM, Chan M, Low JL, et al. The impact of sink removal and other water-free interventions in intensive care units on water-borne healthcare-associated infections: a systematic review. J Hosp Infect, 2024, 150: 61-71.
55. 喬甫, 衛麗, 莊紅娣, 等. 含氯己定醇的速干手消毒劑對常見多重耐藥菌殺滅效果研究. 華西醫學, 2017, 32(3): 375-376.
56. Fan CY, Lee WT, Hsu TC, et al. Effect of chlorhexidine bathing on colonization or infection with Acinetobacter baumannii: a systematic review and meta-analysis. J Hosp Infect, 2019, 103(3): 284-292.
57. Septimus EJ, Schweizer ML. Decolonization in prevention of health care-associated infections. Clin Microbiol Rev, 2016, 29(2): 201-222.
58. Worldwide Antimicrobial Resistance National/International Network Group (WARNING) Collaborators. Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action. World J Emerg Surg, 2023, 18(1): 50.
59. Levy Hara G, Rojas-Cortés R, Molina León HF, et al. Point prevalence survey of antibiotic use in hospitals in Latin American countries. J Antimicrob Chemother, 2022, 77(3): 807-815.
60. Calderwood MS, Anderson DJ, Bratzler DW, et al. Strategies to prevent surgical site infections in acute-care hospitals: 2022 update. Infect Control Hosp Epidemiol, 2023, 44(5): 695-720.
61. Khilnani GC, Zirpe K, Hadda V, et al. Guidelines for antibiotic prescription in intensive care unit. Indian J Crit Care Med, 2019, 23(Suppl 1): S1-S63.
62. Khilnani GC, Tiwari P, Mittal S, et al. Guidelines for antibiotics prescription in critically ill patients. Indian J Crit Care Med, 2024, 28(Suppl 2): S104-S216.
63. Niederman MS. Adjunctive nebulized antibiotics: what is their place in ICU infections?. Front Med (Lausanne), 2019, 6: 99.
64. Martinez EP, Cepeda M, Jovanoska M, et al. Seasonality of antimicrobial resistance rates in respiratory bacteria: a systematic review and meta-analysis. PLoS One, 2019, 14(8): e0221133.
65. Cave R, Cole J, Mkrtchyan HV. Surveillance and prevalence of antimicrobial resistant bacteria from public settings within urban built environments: challenges and opportunities for hygiene and infection control. Environ Int, 2021, 157: 106836.
66. 楊啟文, 吳安華, 胡必杰, 等. 臨床重要耐藥菌感染傳播防控策略專家共識. 中國感染控制雜志, 2021, 20(1): 1-14.

West China Medical Journal

Risk factors and prevention and control strategies for hospital-acquired multidrug-resistant bacterial infections in intensive care unit patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content