ObjectiveTo evaluate the effect of bundle strategies on the prevention and control of multidrug-resistant organisms (MDROs) in intensive care unit (ICU), in order to effectively prevent and control the severe situation of multiple drug-resistant bacteria in ICU.MethodsWe selected patients who admitted into the ICU from January 2016 to December 2017 as study subjects, and monitored 6 types of MDROs. Basic information was surveyed and collected from January to December 2016 (before intervention), while bundle strategies on MDROs were implemented from January to December 2017 (after intervention), including issusing isolation orders, hanging isolation marks, wearing isolation clothes, using medical articles exclusively, cleaning and disinfecting environment, implementing hand hygiene, etc. Then we compared the MDRO detection rate, nosocomial infection rate, MDRO nosocomial infection rate, and compliance rates of interventions between the two periods.ResultsThe MDRO detection rate before intervention was 77.10%, and that after intervention was 49.12%, the difference between the two periods was statistically significant (χ2=69.834, P<0.001). The nosocomial infection rate of ICU decreased from 23.51% before intervention to 15.23% after intervention, the MDRO nosocomial infection rate decreased from 13.70% before intervention to 5.84% after intervention, and the differences between the two periods were statistically significant (χ2=8.594, P=0.003; χ2=13.722, P<0.001). The compliance rates of doctor’s isolation orders, hanging isolation marks, wearing isolation clothes, using medical articles exclusively, cleaning and disinfecting environment, and hand hygiene, as well as the correct rate of hand hygiene after intervention (92.12%, 93.55%, 81.77%, 84.24%, 82.90%, 77.39%, and 96.37%) were significantly higher than those before intervention (31.94%, 52.00%, 23.43%, 48.18%, 67.16%, 59.46%, and 88.64%), and the differences were all statistically significant (P<0.001).ConclusionThe implementation of the above bundle strategies on the prevention and control of MDROs can decrease the MDRO detection rate and MDRO nosocomial infection rate.
目的 為貫徹落實衛生部《醫院感染管理辦法》、《抗菌藥物合理應用指導原則》，了解成都三六三醫院醫院感染的現狀，對醫院感染控制工作進行評價，提高醫務人員的感染控制意識。 方法 制定統一調查方案與措施，逐一查看2011年9月21日全院住院患者在架病歷，對全院住院患者通過床旁詢問和體檢的方式進行調查。 結果 全院共有住院患者621例，實查621例，實查率100%。發生醫院感染19例，現患率為3.06%。抗生素使用率46.38%。病原學送檢率21.88%。 結論 加強醫務人員醫院感染知識的培訓是提高其醫院感染防控意識的重要手段；提高感染患者病原學送檢率，減少經驗性用藥，依據藥敏結果合理使用抗生素，達到有效減少耐藥菌產生的目的。