Carbapenem-resistant gram-negative bacteria colonized in hair of ICU patients and decolonization effect
OBJECTIVE To investigate the status of colonization of carbapenem-resistant Acinetobacter baumannii(CRAB)and carbapenem-resistant Klebsiella pneumoniae(CRKP)in hair of intensive care unit(ICU)patients and observe the decolonization effects of different hair washing methods.METHODS From Mar 2022 to Mar 2023,the ICU patients of a three-A teaching general hospital who had CRAB and CRKP infection and met the inclusion criteria were enrolled in the study.The patients were treated with different hair washing methods for decoloniza-tion,the control group was treated with conventional washing shampoo,the intervention 1 group was treated with 2％chlorhexidine solution,and the intervention 2 group was treated with 2％chlorhexidine hair washing cap.The hair washing time,isolation rates of CRAB and CRKP,and average bacterial colony counts were observed and comparted among the three groups.RESULTS A total of 105 patients met the inclusion criteria,and totally 345 case-times of bacterial culture were carried out for the hair specimens that were collected from the patients after the hair washing for different time periods.The total isolation rate of CRAB and CRKP of the control group was 42.86％(36/84),higher than 22.40％(28/125)of the intervention 1 group and 12.50％(17/136)of the interven-tion 2 group(P＜0.05),there was no significant difference between the two intervention groups;there were sig-nificant differences in the total bacterial colony counts of hair and the colony counts of gram-negative bacteria a-mong the three groups of patients(P＜0.05).The isolation rate of CRAB(45.31％)of the control group was 4 times the isolation rate of CRKP(11.47％)(c2=15.828,P＜0.001).The hair washing methods of the two inter-vention groups could achieve remarkable effects on decolonization after hair washing for 1 and 3 days(P＜0.05);however,the hair washing method of the intervention 2 group could achieve more remarkable effect after the hair washing for 1 day than after the hair washing for 3 days(P＜0.05);there was significant difference in the hair washing time among the three hair washing methods(P＜0.05),and the hair washing time of the intervention 2 group was the shortest.CONCLUSION The positive rates of isolation of CRAB and CRKP from hair are high a-mong the patients,and the isolation rate of CRAB is higher than that of the CRKP.Both 2％chlorhexidine acetate solution and 2％chlorhexidine glucose cap can effectively reduce the isolation rates of CRAB and CRKP.The hair washing cap may help to save nursing work force,shorten the operation time and raise the satisfaction with nurs-ing.It is worthy to be promoted in the hospital.
Intensive care unitCarbapenem-resistant gram-negative bacteria infectionHairColonizationDecol-onization2％chlorhexidineEffect evaluation
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NSTL
万方数据
维普
