首页|基于透明监管模式对老年病房碳青霉烯耐药革兰阴性杆菌防控成效的研究

基于透明监管模式对老年病房碳青霉烯耐药革兰阴性杆菌防控成效的研究

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目的 探讨在老年病房基于透明监管模式开展对碳青霉烯耐药革兰阴性杆菌(carbapenem resistant Gram-negative bacilli,CRO)防控的成效.方法 选择2018年1月-2022年12月连云港市第一人民医院老年病房患者.于2019年建立并推行针对CRO的透明监管模式,包括成立监管小组,制定集束化防控措施,推行透明提醒、公示、督查与考核等管理措施.比较分析不同年间的CRO检出率与感染发现率等指标.结果 共监测患者15 015例,共检出CRO418株.医院感染发病率逐年降低(x2=26.666,P<0.001),抗菌药物治疗前病原学送检率逐年提升(x2=280.320,P<0.001).CRO感染发现率逐年下降,但差异无统计学意义(P>0.05);其中,耐碳青霉烯肺炎克雷伯菌感染发现逐年下降,差异有统计学意义(P=0.030).CRO检出率逐年降低(x2=33.593,P<0.001);其中,耐碳青霉烯肺炎克雷伯菌(x2=23.663,P<0.001)和耐碳青霉烯铜绿假单胞菌(x2x=14.527,P=0.006)检出率逐年下降.结论 通过在老年病房建立并推进透明监管模式,可降低耐药菌的检出率与感染发现率,有效提升病房内老年患者CRO的防控成效,保障老年患者安全.
Study on prevention and control effect of carbapenem resistant Gram-negative bacilli in geriatric ward based on transparent supervision model
Objective To explore the prevention and control effect of carbapenem resistant Gram-negative bacillus(CRO)in geriatric ward based on transparent supervision model.Methods Patients admitted to the geriatric ward in the First People's Hospital of Lianyungang between January 2018 and December 2022 were selected.A transparent regulatory model for CRO was established and implemented in 2019,including the establishment of a regulatory group,the development of cluster prevention and control measures,the implementation of transparent reminder,publicity,supervision and assessment and other management measures.We evaluated the effectiveness by comparing the detection rate and infection rate of CRO before and after the intervention.Results A total of 15 015 patients were monitored,and a total of 418 strains of CRO were detected.The incidence rate of noso-comial infection was decreasing year by year(x2=26.666,P<0.001),and the etiological submission rate of hospitalized patients before antimicrobial treatment had been increasing year by year(x2=280.320,P<0.001).The detection rate of CRO infection had been decreasing year by year,but the difference was not statistically significant(P>0.05),and there was statistical significance in the detection rate of carbapenem-resistant Klebsiella pneumonia infection(P=0.030).The detection rate of CRO had been decreasing year by year(x2=33.593,P<0.001),and there was statistical significance in the detection rate of carbapenem-resistant Klebsiella pneumonia(x2=23.663,P<0.001)and carbapenem resistant Pseudomonas aeruginosa(x2=14.527,P=0.006).Conclusions By establishing and promoting transparent supervision mode in the geriatric ward,the detection rate and infection rate of drug-resistant bacteria can be significantly reduced,and the prevention and control effect of CRO in the elderly patients in the ward can be effectively improved to ensure the safety of elderly patients.

Old agetransparent supervisioncarbapenem resistant Gram-negative bacillieffect

左燕、刘菁、陈亚男

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连云港市第一人民医院护理部(江苏连云港 222061)

连云港市第一人民医院感染管理科(江苏连云港 222061)

老年 透明监管 碳青霉烯耐药革兰阴性杆菌 成效

连云港市医院协会医院管理创新研究项目

LYX-M-202319

2024

华西医学
四川大学华西医院

华西医学

CSTPCD
影响因子:0.744
ISSN:1002-0179
年,卷(期):2024.39(3)
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